FORM 1023-EZ for PTA NEW YORK CONGRESS 15-210 ROXBURY CENTRAL SCHOOL PTSA

Field Data
EIN 14-1721145
Case Number EO-2017278-000391
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PTA NEW YORK CONGRESS 15-210 ROXBURY CENTRAL SCHOOL PTSA
Organization’s Mailing Address 53729 STATE HWY 30
City ROXBURY
State NY
ZIP 12474
Accounting period End 8
Primary contact name EILEEN IANNIELLO
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DAWN KALLEBERG
PRESIDENT
STATE HWY 30
ROXBURY NY 12474

Officer/Director/Trustee Two

LELA DAVIS
VICE PRESIDENT
2701 COUNTY HWY 36
MARGARETVILLE NY 12455

Officer/Director/Trustee Three

EILEEN IANNIELLO
TREASURER
40 BRIDGE ST
ROXBURY NY 12474

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/1/2004
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B94 - Parent/Teacher Group
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee No
Donation of funds No
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance No
One Third Support Public Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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