FORM 1023-EZ for DR LENA MCLIN FOUNDATION INC

Field Data
EIN 47-5146745
Case Number EO-2015281-000269
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name DR LENA MCLIN FOUNDATION INC
Organization’s Mailing Address CARE OF JAY B ROSS AND ASSOCIATES
City CHICAGO
State IL
ZIP 60642-6565
Accounting period End 12
Primary contact name JAY B ROSS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

LENA MCLIN
PRESIDENT
6901 S OGLESBY
CHICAGO IL 60649-1827

Officer/Director/Trustee Two

BEVERLY JONES
OFFICER
14045 S LIDIA AVE
ROBBINS IL 60472-2249

Officer/Director/Trustee Three

DELRICK HARRIS
OFFICER
1400 EAST 55TH PLACE
CHICAGO IL 60637-1876

Officer/Director/Trustee Four

KENNETH GRAY
OFFICER
9919 S GREEN ST
CHICAGO IL 60643-2201

Officer/Director/Trustee Five

SANDRA WATKINS
OFFICER
21 DANUBE WAY
OLYMPIA FIELDS IL 60461-1623

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/18/2015
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A60 - Performing Arts Organizations
Organization’s purpose Charitable: Yes
Religious: Yes
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 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 No
One Third Support Gifts Yes
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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