FORM 1023-EZ for NOZZLEMAN MC PA CHAPTER 1 INC

Field Data
EIN 82-1779242
Case Number EO-2018117-000195
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name NOZZLEMAN MC PA CHAPTER 1 INC
Organization’s Mailing Address 51 ZAJAC LANE
City NESCOPECK
State PA
ZIP 18635
Accounting period End 12
Primary contact name CARRIE SOBOLEWSKI
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MARK NEBERDOSKY SR
PRESIDENT
385 PARK AVE
WILKES BARRE PA 18702

Officer/Director/Trustee Two

SHANE BARDO
VICE PRESIDENT
51 ZAJAC LANE
NESCOPECK PA 18635

Officer/Director/Trustee Three

EDWARD MURPHY
SECRETARY
18 W BUTLER ST
SHICKSHINNY PA 18655

Officer/Director/Trustee Four

RYAN DECKER
TREASURER
280 POPLAR ST
LARKSVILLE PA 18651

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/7/17
Organization Incorporation State PA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Z99 - Unclassified
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 SHANE BARDO
Signature Title VICE PRESIDENT
Signature Date 4/25/18

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