FORM 1023-EZ for MARIECLAIRE SAITILMA SIMON FOUNDATION

Field Data
EIN 81-1522799
Case Number EO-2018128-001084
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MARIECLAIRE SAITILMA SIMON FOUNDATION
Organization’s Mailing Address 40048 QUARTER BRANCH ROAD
City LOVETTSILLE
State VA
ZIP 20180
Accounting period End 12
Primary contact name SYNTHIA LOUIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SYNTHIA LOUIS
PRESIDENT
40028 QUARTER BRANCH
LOVETTSVILLE VA 20180

Officer/Director/Trustee Two

MICHELSON JOLIBOIS
VICE PRESIDENT
766 OCEAN AVE
BROOKLYN NY 11226

Officer/Director/Trustee Three

GILBERT BRICE
TREASURY
40028 QUARTER BRANCH
LOVETTSVILLE VA 20180

Officer/Director/Trustee Four

MARY CHALUMEAU
EXECUTIVE DIRECTOR
351 ANAWANDA AVE
PITTSBURG PA 15228

Organization’s website HTTPS://WWW.FACEBOOK.COM/PG/MCSSTHESIMONFOUNDATION/POSTS/
Organization’s email MCSSFOUNDATION@MAILBOX.ORG
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/22/16
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code K30 - Food Service, Free Food Distribution Programs
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: Yes
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee Yes
Donation of funds Yes
Conducting Activities Outside of United States Yes
Financial transactions with officers No
Unrelated Gross Income $1,000 or More Yes
Gaming Activity No
Disaster relief assistance Yes
One Third Support Public No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name SYNTHIA LOUIS
Signature Title PRESIDENT
Signature Date 5/3/18

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