FORM 1023-EZ for FIBROMYALGIA CARE SOCIETY OF AMERICA INC

Field Data
EIN 47-3585746
Case Number EO-2018313-000054
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name FIBROMYALGIA CARE SOCIETY OF AMERICA INC
Organization’s Mailing Address 82 N 11TH ST
City NEWARK
State NJ
ZIP 7107
Accounting period End 12
Primary contact name MILDRED VELEZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MILDRED VELEZ
DIRECTOR
82 N 11TH ST
NEWARK NJ 7107

Officer/Director/Trustee Two

ALEX ROQUE
DIRECTOR
429 TH AVE
BROOKLYN NY 10075

Officer/Director/Trustee Three

KYM GILCHRIST
DIRECTOR
80 PALM STREET
NEWARK NJ 7106

Officer/Director/Trustee Four

MICHELLE YAKOBSON
DIRECTOR
1925 EASTCHESTER ROAD
BRONX NY 10461

Officer/Director/Trustee Five

KYRA BLATT
DIRECTOR
371 EAST 79TH ST
NEW YORK NY 10001

Organization’s website WWW.FIBRO.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/9/15
Organization Incorporation State NJ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P80 - Services to Promote the Independence of Specific Populations
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 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 MILDRED VELEZ
Signature Title DIRECTOR
Signature Date 11/7/18
EIN 47-3585746
Case Number EO-2015124-000095
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name FIBROMYALGIA CARE SOCIETY OF AMERICA INC
Organization’s Mailing Address 82 NORTH 11TH STREET
City NEWARK
State NJ
ZIP 07107
Accounting period End 12
Primary contact name MILDRED VELEZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MILDRED VELEZ
PRESIDENT
82 NORTH 11TH STREET
NEWARK NJ 07107

Officer/Director/Trustee Two

KYM GILCHRIST
SECRETARY
80 PALM STREET
NEWARK NJ 07106

Officer/Director/Trustee Three

ALEXANDER ROQUE
TREASURER
429 5TH AVENUE APT 1
BROOKLYN NY 11215

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/9/2015
Organization Incorporation State NJ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P80 - Services to Promote the Independence of Specific Populations
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 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 No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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