FORM 1023-EZ for THE MANTIS FOUNDATION

Field Data
EIN 84-2359949
Case Number EO-2019234-000228
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name THE MANTIS FOUNDATION
Organization’s Mailing Address PO BOX 159
City CLARENDON
State NY
ZIP 14429
Accounting period End 12
Primary contact name SHARON PELUSIO
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHARON PELUSIO
DIRECTOR AND PRESIDENT
16399 POWERLINE ROAD
HOLLEY NY 14470

Officer/Director/Trustee Two

VINEETA BARONOS
DIRECTOR AND VICE PRESIDENT
7 PIN HOOK LANE
PITTSFORD NY 14534

Officer/Director/Trustee Three

SOO AHN
DIRECTOR AND TREASURER, SECRETARY
18 EDWARDS STREET 2B
ROSLYN HEIGHTS NY 11577

Officer/Director/Trustee Four

STEPHAN MORSE
DIRECTOR
265 MILLBURN STREET
ROCHESTER NY 14607

Organization’s website
Organization’s email THEMANTISFOUNDATION@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/10/19
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P99 - Human Services - Multipurpose and Other N.E.C.
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 Yes
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name SHARON PELUSIO
Signature Title DIRECTOR AND PRESIDENT
Signature Date 8/20/19

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