FORM 1023-EZ for MSA NJ

Field Data
EIN 45-3292847
Case Number EO-2015132-000143
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MSA NJ
Organization’s Mailing Address PO BOX 773
City HOWELL
State NJ
ZIP 07731-1614
Accounting period End 12
Primary contact name CYNTHIA ROEMER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

CYNTHIA ROEMER
PRESIDENT
12 KETTLE CT
HOWELL NJ 07731-1614

Officer/Director/Trustee Two

KYMBERLI ROEMER
EXECUTIVE VICE PRESIDENT
8 REVERE CT
JACKSON NJ 08527

Officer/Director/Trustee Three

RONALD ROEMER
VICE PRESIDENT - FINANCIAL
12 KETTLE CT
HOWELL NJ 07731-1614

Officer/Director/Trustee Four

ROBERT CHARKOWSKY
VICE PRESIDENT - WEB COMMUNICATIONS
219 LIVINGSTON RD
LINDEN NJ 07036

Officer/Director/Trustee Five

CHRISTOPHER CAMPBELL
VICE PRESIDENT - PRODUCT LINE
1412 N 7TH ST
PONCA CITY OK 74601

Organization’s website WWW.MSANJ.ORG
Organization’s email CONTACT@MSANJ.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/28/2012
Organization Incorporation State NJ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G01 - Alliance/Advocacy Organizations
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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