FORM 1023-EZ for LEGACY CARE CLUB

Field Data
EIN 83-4241729
Case Number EO-2020006-000476
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LEGACY CARE CLUB
Organization’s Mailing Address 38 UNION STREET UNIT 2
City JERSEY CITY
State NJ
ZIP 07304
Accounting period End 12
Primary contact name JODYANN BLAGROVE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MAXINE BRAHAM-WILLOUGHBY
DIRECTOR
800 FANNING MILL RD
STEWARTSVILLE NJ 08886

Officer/Director/Trustee Two

INGRID COPPIN
DIRECTOR
1654 FOX HOLLOW
EASTON PA 18040

Officer/Director/Trustee Three

CHERYL BAXTER
DIRECTOR
57 CORNERSTONE LANE
NEWARK NJ 07103

Officer/Director/Trustee Four

AYANA EVANS
DIRECTOR
255 WEST 43RD ST UNIT 927
NEW YORK NY 10036

Officer/Director/Trustee Five

JODYANN BLAGROVE
DIRECTOR
38 UNION ST UNIT 2
JERSEY CITY NJ 07304

Organization’s website HTTPS://LEGACYCARES.WIXSITE.COM/SENIORS
Organization’s email JODYB30@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/2/2019
Organization Incorporation State NJ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P81 - Senior Centers, Services
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 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 JODYANN BLAGROVE
Signature Title DIRECTOR
Signature Date 1/3/2020

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