FORM 1023-EZ for SIMMONS LACROSSE FOUNDATION INC

Field Data
EIN 27-2187737
Case Number EO-2018247-000668
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SIMMONS LACROSSE FOUNDATION INC
Organization’s Mailing Address 310 WEST CHOCOLATE AVE
City HERSHEY
State PA
ZIP 17033
Accounting period End 12
Primary contact name MARK WINTER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MARK WINTER
TREASURER
310 WEST CHOCOLATE AVE
HERSHEY PA 17033

Officer/Director/Trustee Two

FREDRIC CAMBRIA
PRESIDENT
115 PAINE AVE
NEW ROCHELLE NY 10804

Officer/Director/Trustee Three

CHRISTOPHER BURT
VICE PRESIDENT
123 WAHACKME RD
NEW CANAAN CT 6840

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/26/10
Organization Incorporation State PA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N02 - Management & Technical Assistance
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
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 Yes
Correctness Declaration Yes
Signature Name MARK WINTER
Signature Title TREASURER
Signature Date 8/31/18

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