FORM 1023-EZ for ILL FOUNDATION INC

Field Data
EIN 81-1516958
Case Number EO-2016057-000077
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ILL FOUNDATION INC
Organization’s Mailing Address 6742 FOREST HILL BLVD SUITE 209
City WEST PALM BEACH
State FL
ZIP 33431
Accounting period End 12
Primary contact name MARLINE POTTINGER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DOYLE CHAMBERS
DIRECTOR
4892 LOMBARD PASS DRIVE
LAKE WORTH

Officer/Director/Trustee Two

LLEWELLYN BROWN
EXECUTIVE DIRECTOR
125 HARBOR LAKE CIRCLE
GREENACRES FL 33413

Officer/Director/Trustee Three

MARLINE POTTINGER
TREASURER
11771 W ATLANTIC BLVD APT 33
CORAL SPRINGS FL 33071

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/11/2016
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O20 - Youth Centers, Clubs, 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 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
Signature Title
Signature Date

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