FORM 1023-EZ for SECRET SANTA INITIATIVE

Field Data
EIN 84-3822124
Case Number EO-2020181-000171
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SECRET SANTA INITIATIVE
Organization’s Mailing Address 412 N ALMA CT
City BRIMFIELD
State IL
ZIP 61517
Accounting period End 12
Primary contact name JEFFREY ROYER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JEFFREY ROYER
PRESIDENT
412 N ALMA CT
BRIMFIELD IL 61517

Officer/Director/Trustee Two

MARISSA ROYER
VICE PRESIDENT
412 N ALMA CT
BRIMFIELD IL 61517

Officer/Director/Trustee Three

STACY HARDIN
SECRETARY
4408 N KNOXVILLE 2C
PEORIA IL 61614

Officer/Director/Trustee Four

DEMARIO BOONE
OFFICER
2100 N WISCONSIN AVE
PEORIA IL 61603

Officer/Director/Trustee Five

ANDY WAGENBACH
OFFICER
20237 STATE ROUTE 9
PEKIN IL 61554

Organization’s website
Organization’s email JEFFREY.ROYER@PSD150.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/13/2019
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P58 - Gift 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 Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name JEFFREY ROYER
Signature Title PRESIDENT
Signature Date 6/25/2020

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