FORM 1023-EZ for PEMBROKE ANONYMOUS INC

Field Data
EIN 82-2249887
Case Number EO-2017209-000290
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PEMBROKE ANONYMOUS INC
Organization’s Mailing Address 9 ROCKVIEW WAY
City ROCKLAND
State MA
ZIP 02370
Accounting period End 12
Primary contact name LAILA TEHRANIAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LAILA TEHRANIAN
PRESIDENT, DIRECTOR
171 PRISCILLA DR
PEMBROKE MA 02359

Officer/Director/Trustee Two

KENNETH HORN
SECRETARY, DIRECTOR
39 FARMSIDE DR
PEMBROKE MA 02359

Officer/Director/Trustee Three

LINDA FEDERICO
TREASURER, DIRECTOR
307 FOREST ST
PEMBROKE MA 02359

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/19/2017
Organization Incorporation State MA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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 Yes
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 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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