FORM 1023-EZ for ELDERLY SUPPORT SERVICES INC

Field Data
EIN 47-3895143
Case Number EO-2015126-000198
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ELDERLY SUPPORT SERVICES INC
Organization’s Mailing Address 29 SARATOGA ST
City LOWELL
State MA
ZIP 01852
Accounting period End 12
Primary contact name SHAWN LOR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

SHAWN LOR
PRESIDENT
29 SARATOGA ST
LOWELL MA 01852

Officer/Director/Trustee Two

PROS NGETH
VICE PRESIDENT
8911 ENSENADA DR
STOCKTON CA 95210

Officer/Director/Trustee Three

RENNY CHANEY
SECRETARY
7 WALKER ST
LOWELL MA 01851

Officer/Director/Trustee Four

SITHY DEE
TREASURER
180 WASHINGTON DR
MILPITAS CA 95035

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/4/2015
Organization Incorporation State MA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P80 - Services to Promote the Independence of Specific Populations
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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