FORM 1023-EZ for SURVIVOR JOURNEYS INC

Field Data
EIN 47-3109711
Case Number EO-2015082-000210
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SURVIVOR JOURNEYS INC
Organization’s Mailing Address 2 SOUTH BRIDGE DRIVE
City AGAWAM
State MA
ZIP 01001-2000
Accounting period End 12
Primary contact name JENELLE C DODDS ESQ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JAY BURTON
PRESIDENT
396 INVERNESS ROAD
LONGMEADOW MA 01106-2826

Officer/Director/Trustee Two

SEAN WANDREI
TREASURER
23 OTTAWA STREET
AGAWAM MA 01001-1218

Officer/Director/Trustee Three

VINCENT PETRANGELO
SECRETARY
43 WESTERN AVENUE
WESTFIELD MA 01085-2614

Officer/Director/Trustee Four

MARY ANN PALEOLOGPOULOS
DIRECTOR
164 RIVER ROAD
AGAWAM MA 01001-2816

Officer/Director/Trustee Five

JAY PRESSER
DIRECTOR
887 MAPLETON AVE
SUFFIELD CT 06078-1328

Organization’s website WWW.SURVIVORJOURNEYS.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/3/2015
Organization Incorporation State MA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F60 - Counseling, Support Groups
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 Yes
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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