FORM 1023-EZ for ROCKFORD MEMORIAL HOSPITAL NURSES ALUMNI ASSOCIATION

Field Data
EIN 84-1746913
Case Number EO-2019220-000257
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ROCKFORD MEMORIAL HOSPITAL NURSES ALUMNI ASSOCIATION
Organization’s Mailing Address 295 BUNKER HILL DR
City BROOKFIELD
State WI
ZIP 53005
Accounting period End 12
Primary contact name MARY JOHNSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MARY JOHNSON
PRESIDENT
295 BUNKER HILL DR
BROOKFIELD WI 53005

Officer/Director/Trustee Two

PAT ESKER
VICE PRESIDENT
1310 SOUTH HEITER RD
PEARL CITY IL 61062

Officer/Director/Trustee Three

PATRICIA HYDE
TREASURER
9255 FOREST RIDGE DRIVE
ROSCOE IL 61073

Officer/Director/Trustee Four

JEAN VITALE
BOARD MEMBER
5552 NORTHCLIFFE LANE
ROCKFORD IL 61114

Officer/Director/Trustee Five

LISA MILLER
BOARD MEMBER
6328 ALTUS DRIVE
LOVES PARK IL 61111

Organization’s website
Organization’s email RMHALUMNI@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/25/18
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E03 - Professional Societies, Associations
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
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 MARY JOHNSON
Signature Title PRESIDENT
Signature Date 8/6/19

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