FORM 1023-EZ for MEMORIAL BREAKFAST AND MASS INC

Field Data
EIN 81-5333255
Case Number EO-2017166-000106
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MEMORIAL BREAKFAST AND MASS INC
Organization’s Mailing Address 990 EAST 331 ST
City EASTLAKE
State OH
ZIP 44095
Accounting period End 5
Primary contact name SCOTT BUCKLEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TERRY GELLNER
CHAIRPERSON
38400 WESTMINSTER LN
WILLOUGHBY OH 44094

Officer/Director/Trustee Two

JOY GOBEC
SECRETARY
11732 LAKE AVE 304
LAKEWOOD OH 44107

Officer/Director/Trustee Three

SCOTT BUCKLEY
TREASURER
990 EAST 331 ST
EASTLAKE OH 44095

Officer/Director/Trustee Four

BARBARA NICHOLS
ASST TREASURER
674 CROSSINGS CIRCLE
TALLMADGE OH 44278

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/19/2017
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E11 - Single Organization Support
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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