FORM 1023-EZ for MADIA FOUNDATION NFP

Field Data
EIN 81-3281381
Case Number EO-2016308-000299
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MADIA FOUNDATION NFP
Organization’s Mailing Address 7437 W IRVING PARK RD
City CHICAGO
State IL
ZIP 60634
Accounting period End 8
Primary contact name MARK STRICKLIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DIANA LISICKA
PRESIDENT
3906 WEHRMAN AVE
SCHILLER PARK IL 60176

Officer/Director/Trustee Two

MARK STRICKLIN
SECRETARY
37571 N LAKE CREST AVE
BEACH PARK IL 60087

Officer/Director/Trustee Three

TONYA CLARK
TREASURER
38966 LINDEN AVE
BEACH PARK IL 60099

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/19/2016
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T12 - Fund Raising and/or Fund Distribution
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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