FORM 1023-EZ for AUSTIN SHELLHAUSE FOUNDATION NFP

Field Data
EIN 83-1093762
Case Number EO-2019039-000506
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name AUSTIN SHELLHAUSE FOUNDATION NFP
Organization’s Mailing Address 2262 GLENVIEW DR
City FREEPORT
State IL
ZIP 61032
Accounting period End 12
Primary contact name GINA HOCKMAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

GINA HOCKMAN
CEO
2262 GLENVIEW DR
FREEPORT IL 61032

Officer/Director/Trustee Two

JENNIFER KIPEE
OFFICER
5745 CRANES GROVE RD
FREEPORT IL 61032

Officer/Director/Trustee Three

HANNAH SHELLHAUSE
OFFICER
2540 SUNSET DR APT 77
LONGMONT CO 80501

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/16/19
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B82 - Scholarships, Student Financial Aid Services, Awards
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 GINA HOCKMAN
Signature Title CEO
Signature Date 2/4/19

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