FORM 1023-EZ for PALLIATIVE CARE INITIATIVE INC

Field Data
EIN 20-2792943
Case Number EO-2016032-000311
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PALLIATIVE CARE INITIATIVE INC
Organization’s Mailing Address 592 SAW MILL BROOK PARKWAY
City NEWTON
State MA
ZIP 92459
Accounting period End 12
Primary contact name MARINA BIALIK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MARINA BIALIK
PRESIDENT AND DIRECTOR
592 SAW MILL BROOK PARKWAY
NEWTON MA 02459

Officer/Director/Trustee Two

SERGEY ARKANIKOV
TREASURE
808 MEMORIAL DR 514
CAMBRIDGE MA 02139

Officer/Director/Trustee Three

LYUDMILA TAYTSLIN
DIRECTOR
118 WILSON DR
FRAMINGHAM MA 01702

Officer/Director/Trustee Four

CAROLYN SMITH
DIRECTOR
358 STARLING RD
MILL VALLEY CA 94941

Officer/Director/Trustee Five

MARINA BIALIK
SECRETAR
592 SAW MILL BROOK PARKWAY
NEWTON MA 02459

Organization’s website WWW.PPCI.CHOOSINGHOPE.INFO
Organization’s email CHOOSING.HOPE@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/2/2005
Organization Incorporation State MA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B01 - Alliance/Advocacy Organizations
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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