FORM 1023-EZ for JOG YOUR MEMORY 5K INC

Field Data
EIN 47-3156339
Case Number EO-2015063-000096
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name JOG YOUR MEMORY 5K INC
Organization’s Mailing Address 64 HAWTHORN AVE
City NEEDHAM
State MA
ZIP 02492
Accounting period End 6
Primary contact name JESSICA LASTARZA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JESSICA RICE
PRESIDENT, DIRECTOR
64 HAWTHORN AVENUE
NEEDHAM MA 02492-3806

Officer/Director/Trustee Two

ROBERT RICE
TREASURER, DIRECTOR
64 HAWTHORN AVENUE
NEEDHAM MA 02492-3806

Officer/Director/Trustee Three

RICHARD CALEY
SECRETARY, DIRECTOR
17 CEDAR STREET
GRANBY CT 06035

Officer/Director/Trustee Four

MICHELLE VITAGLIANO
DIRECTOR
1404 COMMONWEALTH AVE APT 15
BRIGHTON MA 02134

Officer/Director/Trustee Five

HARRY STANTS
DIRECTOR
65 BEAUFORT AVE
NEEDHAM MA 02492

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/18/2015
Organization Incorporation State MA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G83 - Alzheimer's Disease
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 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
Signature Title
Signature Date

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