FORM 1023-EZ for YAD NISIM AND EZER YAKOB INC

Field Data
EIN 86-2380610
Case Number EO-2021104-000096
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name YAD NISIM AND EZER YAKOB INC
Organization’s Mailing Address 4 SANZ TOWN ROAD
City LAKEWOOD
State NJ
ZIP 08701
Accounting period End 12
Primary contact name DAVID HUTMAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SALLY HASSAN
TRUSTEE
4 SANZ TOWN RD
LAKEWOOD NJ 08701

Officer/Director/Trustee Two

ANETTE LOUSKY
TRUSTEE
213 14TH ST
LAKEWOOD NJ 08701

Officer/Director/Trustee Three

MOUSSA SWED
TRUSTEE
623 AVENUE W
BROOKLYN NY 11223

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/3/2021
Organization Incorporation State NJ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P99 - Human Services - Multipurpose and Other N.E.C.
Organization’s purpose Charitable: Yes
Religious: Yes
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 SALLY HASSAN
Signature Title TRUSTEE
Signature Date 4/7/2021

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