FORM 1023-EZ for ZANDRA TLC FOUNDATION INC

Field Data
EIN 81-4728993
Case Number EO-2017048-000169
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ZANDRA TLC FOUNDATION INC
Organization’s Mailing Address 40 BAME AVE
City BUFFALO
State NY
ZIP 14215
Accounting period End 12
Primary contact name TAMARA LEWIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TAMARA LEWIS
EXECUTIVE DIRECTOR
40 BAME
BUFFALO NY 14215

Officer/Director/Trustee Two

KATA ASOLDATENKO
PRESIDENT
78 CULVER STREET
BUFFALO NY 14215

Officer/Director/Trustee Three

SCOTT CRACE
VICE PRESIDENT
468 DELAWARE AVENUE
BUFFALO NY 14215

Officer/Director/Trustee Four

SIMONE COWAN
SECRETARY/TREASURER
4298 SAVANNAH DRIVE
ATLANTA GA 30349

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/30/2017
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E70 - Public Health Program (Includes General Health and Wellness Promotion Services)
Organization’s purpose Charitable: No
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 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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