FORM 1023-EZ for KELLY PAIGE WELLS PERINATAL FUND

Field Data
EIN 84-4161471
Case Number EO-2020021-000677
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name KELLY PAIGE WELLS PERINATAL FUND
Organization’s Mailing Address 3614 W 109TH ST
City CHICAGO
State IL
ZIP 60655-3213
Accounting period End 12
Primary contact name BENJAMIN WELLS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BENJAMIN WELLS
VICE PRESIDENT
3614 W 109TH ST
CHICAGO IL 60655-3213

Officer/Director/Trustee Two

KATIE WELLS
PRESIDENT
3614 W 109TH ST
CHICAGO IL 60655-3213

Officer/Director/Trustee Three

NORA MCCUAN
TREASURER
8329 S SCOTTSDALE AVE
CHICAGO IL 60652

Officer/Director/Trustee Four

CHRISTINA PENDER
SECRETARY
9221 CRESCENT CT
OAK LAWN IL 60453

Organization’s website
Organization’s email KELLYSCREW72@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/4/2020
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F60 - Counseling, Support Groups
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 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 BENJAMIN WELLS
Signature Title VICE PRESIDENT
Signature Date 1/18/2020

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