FORM 1023-EZ for STAAR OVARIAN CANCER

Field Data
EIN 84-4672869
Case Number EO-2020044-000472
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name STAAR OVARIAN CANCER
Organization’s Mailing Address 3835 CENTRAL AVE
City WESTERN SPRINGS
State IL
ZIP 60558
Accounting period End 12
Primary contact name JESSICA BECRAFT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JESSICA BECRAFT
CO-FOUNDER
3835 CENTRAL AVE
WESTERN SPRINGS IL 60558

Officer/Director/Trustee Two

ALEXANDRA FELDT
CO-FOUNDER
119 FAIRVIEW ST
ANN ARBOR MI 48103

Officer/Director/Trustee Three

BAILEY WOLFE
CO-FOUNDER
265 WILDCAT TRACE
PADUKAH KY 42003

Officer/Director/Trustee Four

NICHOLAS GILBERTSON
BOARD MEMBER
397 S YORK ST
ELMHURST IL 60126

Officer/Director/Trustee Five

SOLANGE-MARIE VELAZQUEZ
BOARD MEMBER
860 W BLACKHAWK ST UNIT 1606
CHICAGO IL 60642

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/10/2020
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code H12 - 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 No
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name JESSICA BECRAFT
Signature Title CO-FOUNDER
Signature Date 2/11/2020

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