FORM 1023-EZ for LILLIANAS HEART ASSOCIATION INC

Field Data
EIN 87-2123561
Case Number EO-2021263-000203
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LILLIANAS HEART ASSOCIATION INC
Organization’s Mailing Address 2275 STATE RT 104
City ONTARIO
State NY
ZIP 14519
Accounting period End 12
Primary contact name CHANEL CHARTRAND
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CHANEL CHARTRAND
PRESIDENT & DIRECTOR
2275 STATE RT 104
ONTARIO NY 14519

Officer/Director/Trustee Two

CHRISTOPHER TIERSON
TREASURER & DIRECTOR
2275 STATE RT 104
ONTARIO NY 14519

Officer/Director/Trustee Three

PAMELA SOUCY
SECRETARY & DIRECTOR
6228 STATE RT 21
WILLIAMSON NY 14519

Officer/Director/Trustee Four

MAUREEN MUELLER
DIRECTOR
598 ELWOOD RD
EAST NORTHPORT NY 11731

Organization’s website LILLIANASHEARTASSOCIATION.ORG
Organization’s email CONTACT@LILLIANASHEARTASSOCIATION.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/30/2021
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G20 - Birth Defects and Genetic Diseases
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 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 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 CHANEL CHARTRAND
Signature Title PRESIDENT & DIRECTOR
Signature Date 9/16/2021

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