FORM 1023-EZ for HALEYS HEROES OF HOPE CANCER FOUNDATION INC

Field Data
EIN 46-3724411
Case Number EO-2015120-000182
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HALEYS HEROES OF HOPE CANCER FOUNDATION INC
Organization’s Mailing Address 909 N 11TH ST
City HERRIN
State IL
ZIP 62948
Accounting period End 12
Primary contact name AMY ROSS PHONE 618-727-4447
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JULIE SHAW
PRESIDENT
312 S ODLE ST
WEST FRANKFORT IL 62896

Officer/Director/Trustee Two

DEAN BORCKY
VICE PRESIDENT
2108 E MAIN ST
WEST FRANKFORT IL 62896

Officer/Director/Trustee Three

LEANN AARON
TREASURER
1345 SANDBURG RD
WEST FRANKFORT IL 62896

Officer/Director/Trustee Four

AMY ROSS
DIRECTOR
909 N 11TH ST
HERRIN IL 62948

Officer/Director/Trustee Five

PATRICIA MALDONADO
DIRECTOR
412 MAPLE ST
ZEIGLER IL 62999

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/24/2013
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E86 - Patient Services - Entertainment, Recreation
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
Signature Title
Signature Date

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