FORM 1023-EZ for BELVIDERE FOX TROT FOR PARKINSONS RESEARCH INC

Field Data
EIN 38-3927201
Case Number EO-2014240-000553
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BELVIDERE FOX TROT FOR PARKINSONS RESEARCH INC
Organization’s Mailing Address 708 PAHAQUARRY STREET
City BELVIDERE
State NJ
ZIP 07823-0034
Accounting period End 12
Primary contact name HAROLD HALVORSEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

HAROLD HALVORSEN
TRUSTEE
708 PAHAQUARRY STREET
BELVIDERE NJ 07823-2021

Officer/Director/Trustee Two

MARY HALVORSEN
TRUSTEE
708 PAHAQUARRY STREET
BELVIDERE NJ 07823-2021

Officer/Director/Trustee Three

ADAM HALVORSEN
TRUSTEE
295 KINGSLAND AVE
BROOKLYN NY 11222-3708

Organization’s website FOXTROT5K.ORG
Organization’s email FOXTROT5K@ME.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/13/2014
Organization Incorporation State NJ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G80 - Specifically Named Diseases
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
Signature Title
Signature Date

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