FORM 1023-EZ for EXCLUSIVE PEAKS FOUNDATION

Field Data
EIN 81-4773166
Case Number EO-2017166-000160
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name EXCLUSIVE PEAKS FOUNDATION
Organization’s Mailing Address 842 S SCOVILLE AVE 3
City OAK PARK
State IL
ZIP 60304
Accounting period End 11
Primary contact name ERIC REJMAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ERIC REJMAN
DIRECTOR
842 S SCOVILLE AVE 3
OAK PARK IL 60304

Officer/Director/Trustee Two

STEVE DRISCOLL
DIRECTOR
610 SHERWOOD ROAD
LA GRANGE PARK IL 60526

Officer/Director/Trustee Three

MARLENA MOSBACHER
DIRECTOR
842 S SCOVILLE AVE 3
OAK PARK IL 60304

Organization’s website HTTP://WWW.EXCLUSIVEPEAKS.ORG
Organization’s email EXCLUSIVEPEAKS@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/1/2016
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code C01 - Alliance/Advocacy Organizations
Organization’s purpose Charitable: No
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 Yes
Donation of funds No
Conducting Activities Outside of United States No
Financial transactions with officers Yes
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
Signature Title
Signature Date

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