FORM 1023-EZ for I AM A SURVIVOR PHOTOGRAPHY
| Field | Data |
|---|---|
| EIN | 83-3172593 |
| Case Number | EO-2019036-000337 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | I AM A SURVIVOR PHOTOGRAPHY |
| Organization’s Mailing Address | 409 PENDIK RD |
| City | JACKSONVILLE |
| State | IL |
| ZIP | 62650 |
| Accounting period End | 1 |
| Primary contact name | TRACY MARIE FRICKE |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
TRACY FRICKE
PRESIDENT/OWNER
409 PENDIK RD
JACKSONVILLE IL 62650-3257
Officer/Director/Trustee Two
GARY NEVINS
BOARD MEMBER
6 CELESTE COURT
SPRINGFIELD IL 62703-4717
Officer/Director/Trustee Three
JENNIFER LIPE
BOARD MEMBER
2212 E KEYS
SPRINGFIELD IL 62702-4242
Officer/Director/Trustee Four
GREGORY WILLIAMS
BOARD MEMBER
947 RIVER DRIVE
MUNSTER IN 46321-1308
Officer/Director/Trustee Five
WHITNEY WHITE
BOARD MEMBER
1168 E 318TH RD
FLEMINGTON MO 65650-9544
| Organization’s website | IAMASURVIVORPHOTOGRAPHY.COM |
|---|---|
| Organization’s email | TRACY.FRICKE@YAHOO.COM |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 11/14/18 |
| Organization Incorporation State | IL |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | W12 - 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 | TRACY FRICKE |
| Signature Title | PRESIDENT/OWNER |
| Signature Date | 1/17/19 |
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