FORM 1023-EZ for PALTH INC

Field Data
EIN 86-2074010
Case Number EO-2021091-000828
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PALTH INC
Organization’s Mailing Address 2266 BATH AVE UNIT 3008
City BROOKLYN
State NY
ZIP 11214
Accounting period End 12
Primary contact name ANA RINKOVSKY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MICHELLE BURY-JOHNSON
PRESIDENT
2266 BATH AVE UNIT 3008
BROOKLYN NY 11214

Officer/Director/Trustee Two

CONNIE CABRERA
SECRETARY
2266 BATH AVE UNIT 3008
BROOKLYN NY 11214

Officer/Director/Trustee Three

BASIA LEON
TREASURER
2266 BATH AVE UNIT 3008
BROOKLYN NY 11214

Officer/Director/Trustee Four

ANA RINKOVSKY
DIRECTOR
2266 BATH AVE UNIT 3008
BROOKLYN NY 11214

Organization’s website
Organization’s email ANAR0084@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/11/2021
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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 Yes
Donation of funds Yes
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 ANA RINKOVSKY
Signature Title DIRECTOR
Signature Date 2/22/2021

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