FORM 1023-EZ for PT FWD

Field Data
EIN 84-3478471
Case Number EO-2019301-000590
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PT FWD
Organization’s Mailing Address 1709 E TAYLOR ST
City BLOOMINGTON
State IL
ZIP 61701
Accounting period End 9
Primary contact name EDWARD W BREITWEISER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

EDWARD BREITWEISER
EXECUTIVE DIRECTOR
1709 E TAYLOR ST
BLOOMINGTON IL 61701

Officer/Director/Trustee Two

DAVID DOW
DIRECTOR
219 IMPERIAL DRIVE
BLOOMINGTON IL 61701

Officer/Director/Trustee Three

JIM NEELEY
DIRECTOR
219 IMPERIAL DRIVE
BLOOMINGTON IL 61701

Officer/Director/Trustee Four

ZACHARY BUCKLEY
DIRECTOR
1600 NORTHBROOK DR APT 5A
NORMAL IL 61761

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/4/19
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A20 - Arts, Cultural Organizations - Multipurpose
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 EDWARD BREITWEISER
Signature Title EXECUTIVE DIRECTOR
Signature Date 10/24/19

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