FORM 1023-EZ for LEWY BODY DEMENTIA RESOURCE CENTEROF NEW YORK INC

Field Data
EIN 81-1458076
Case Number EO-2016071-000184
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LEWY BODY DEMENTIA RESOURCE CENTEROF NEW YORK INC
Organization’s Mailing Address 750 WEST BROADWAY 2R
City LONG BEACH
State NY
ZIP 11561
Accounting period End 12
Primary contact name NORMA LOEB
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

NORMA LOEB
CHIEF OPERATING OFFICER
750 WEST BROADWAY 2R
LONG BEACH NY 11561

Officer/Director/Trustee Two

ILEENE STERN
TREASURER AND FAMILY SVCS DIRECTOR
750 WEST BROADWAY 2R
LONG BEACH NY 11561

Officer/Director/Trustee Three

JAMES GALVIN
CHAIRPERSON
750 WEST BROADWAY 2R
LONG BEACH NY 11561

Officer/Director/Trustee Four

MARISA STEFATOS
DIRECTOR OF PROGRAMMING
750 WEST BROADWAY 2R
LONG BEACH NY 11561

Officer/Director/Trustee Five

SUZANNE PARGAMENT
DIRECTOR OF SOCIAL SERVICES
750 WEST BROADWAY 2R
LONG BEACH NY 11561

Organization’s website
Organization’s email NORMALANNE@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/8/2016
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G48 - Brain Disorders
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
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 Yes
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 No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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