FORM 1023-EZ for SHORE RESIDENTIAL LIVING INC

Field Data
EIN 84-2762409
Case Number EO-2019268-000259
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SHORE RESIDENTIAL LIVING INC
Organization’s Mailing Address 34 W PAMPANO DRIVE
City BRICK
State NJ
ZIP 8723
Accounting period End 12
Primary contact name THOMAS KAY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

THOMAS M KAY
PRESIDENT
34 W PAMPANO DRIVE
BRICK NJ 8723

Officer/Director/Trustee Two

LISA LOGRANO
TRUSTEE
29 FALCON RIDGE CIRCLE
HOLMDEL NJ 7733

Officer/Director/Trustee Three

LISA MILLER
TRUSTEE
12 FOREST STREET
WEST LONG BRANCH NJ 7764

Officer/Director/Trustee Four

PATRICIA KAY
TRUSTEE
915 CARLETON ROAD
WESTFIELD NJ 7090

Officer/Director/Trustee Five

JAMES KERVICK
TRUSTEE
22 KIMBERLY DRIVE
OCEAN NJ 7712

Organization’s website
Organization’s email TKWESTFIELD@AOL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/25/19
Organization Incorporation State NJ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P82 - Developmentally Disabled Centers, Services
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 THOMAS M KAY
Signature Title PRESIDENT
Signature Date 9/23/19

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