FORM 1023-EZ for SAMPASA NORTH AMERICA INC

Field Data
EIN 85-2278587
Case Number EO-2020233-000259
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SAMPASA NORTH AMERICA INC
Organization’s Mailing Address 111 S FRANKLIN AVE PO BOX 843
City VALLEY STREAM
State NY
ZIP 11582-0843
Accounting period End 12
Primary contact name AINSWORTH ANDREWS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

IVAN MORGAN
PRESIDENT
111 S FRANKLIN AVE PO BOX 843
VALLEY STREAM NY 11582-0843

Officer/Director/Trustee Two

AINSWORTH ANDREWS
TREASURER
111 S FRANKLIN AVE PO BOX 843
VALLEY STREAM NY 11582-0841

Officer/Director/Trustee Three

BRIAN FARRELL
VICE PRESIDENT
111 S FRANKLIN AVE PO BOX 843
VALLEY STREAM NY 11582-0841

Officer/Director/Trustee Four

SUSAN HAMLET
PUBLIC RELATIONS OFFICER
111 S FRANKLIN AVE PO BOX 843
VALLEY STREAM NY 11582-0841

Officer/Director/Trustee Five

KENDALL BRAMBLE
RECORDING SECRETARY
111 S FRANKLIN AVE PO BOX 843
VALLEY STREAM NY 11582-0841

Organization’s website WWW.SAMPASA.ORG
Organization’s email SAMPASA20@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/7/2020
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B84 - Alumni Associations
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 Yes
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity Yes
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 AINSWORTH ANDREWS
Signature Title TREASURER
Signature Date 8/18/2020

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