FORM 1023-EZ for MOBILE COMMUNITY SHOWER & WELLNESSSERVICES INC

Field Data
EIN 85-3656487
Case Number EO-2021083-000740
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MOBILE COMMUNITY SHOWER & WELLNESSSERVICES INC
Organization’s Mailing Address 408 E 144TH ST STE 6
City BRONX
State NY
ZIP 10454
Accounting period End 12
Primary contact name SAMUEL CABASSA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SAMUEL CABASSA
DIRECTOR
408 E 144TH ST STE 6
BRONX NY 10454

Officer/Director/Trustee Two

CHARLES NELSON
DIRECTOR
408 E 144TH ST STE 6
BRONX NY 10454

Officer/Director/Trustee Three

DAMIAN GARDNER
DIRECTOR
408 E 144TH ST STE 6
BRONX NY 10454

Officer/Director/Trustee Four

LORRAINE WOLTMAN
CHAIRMAN
408 E 144TH ST STE 6
BRONX NY 10454

Officer/Director/Trustee Five

RONALD ROBERTSON
VICE CHAIRMAN
408 E 144TH ST STE 6
BRONX NY 10454

Organization’s website MCSWS.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/13/2020
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P85 - Homeless Persons Centers, Services
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 SAMUEL CABASSA
Signature Title DIRECTOR
Signature Date 11/16/2020

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