FORM 1023-EZ for PETER SHUKAT FOUNDATION INC

Field Data
EIN 81-3168839
Case Number EO-2017058-000677
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PETER SHUKAT FOUNDATION INC
Organization’s Mailing Address 605 THIRD AVENUE FL 34
City NEW YORK
State NY
ZIP 10158
Accounting period End 12
Primary contact name STEPHANIE SALVATORE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JUSTIN SHUKAT
DIRECTOR
96 OAKDALE LANE
ROSLYN HEIGHTS NY 11577

Officer/Director/Trustee Two

YVETTE SHUKAT
DIRECTOR
29 HICKORY DRIVE
GREAT NECK NY 11021

Officer/Director/Trustee Three

JONAS HERBSMAN
DIRECTOR
62 ISELIN TERRACE
LARCHMONT NY 10538

Officer/Director/Trustee Four

MICHELLE SULLIVAN
DIRECTOR
100 GRAND STREET APT 2
NEW YORK NY 10013

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/7/2016
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A99 - Arts, Culture, and Humanities N.E.C.
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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