FORM 1023-EZ for ALIVE OUTREACH

Field Data
EIN 84-2707397
Case Number EO-2021162-000163
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ALIVE OUTREACH
Organization’s Mailing Address 21141 GOVERNORS HWY SUITE 102
City MATTESON
State IL
ZIP 60443
Accounting period End 12
Primary contact name JEROME EUGENE COOK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JEROME COOK
PRESIDENT
318 GETTYSBURG
PARK FOREST IL 60466

Officer/Director/Trustee Two

JUAN ELLIS
DIRECTOR
14021 S GRACE AVENUE
ROBBINS IL 60472

Officer/Director/Trustee Three

BRAD FRAZIER
DIRECTOR
21141 GOVERNORS HWY SUITE 102
MATTESON IL 60443

Officer/Director/Trustee Four

LINDA ABERCROMBIE
TRUSTEE
21141 GOVERNORS HWY SUITE 102
MATTESON IL 60443

Organization’s website WWW.ALIVECHURCH1.ORG
Organization’s email INFO@ALIVECHURCH1.ORG
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/4/2019
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X12 - 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 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 JEROME COOK
Signature Title PRESIDENT
Signature Date 6/9/2021

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