FORM 1023-EZ for VITAS VOCATIONAL INDIVIDUALIZED TRAINING ADVOCATES SERVICES NFP

Field Data
EIN 81-0911767
Case Number EO-2016362-000350
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name VITAS VOCATIONAL INDIVIDUALIZED TRAINING ADVOCATES SERVICES NFP
Organization’s Mailing Address 6900 ROOSEVELT RD
City OAK PARK
State IL
ZIP 60304
Accounting period End 12
Primary contact name DAVITA SHOWERS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DAVITA SHOWERS
PRESIDENT
6900 ROOSEVELT RD
OAK PARK IL 60304

Officer/Director/Trustee Two

DIANA VERSIE
VICE PRESIDENT
6900 ROOSEVELT RD
OAK PARK IL 60304

Officer/Director/Trustee Three

RONNETTA C ANDERSON
SECRETARY
6900 ROOSEVELT RD
OAK PARK IL 60304

Officer/Director/Trustee Four

LETHAL WASHINGTON
TREASURER
6900 ROOSEVELT RD
OAK PARK IL 60304

Officer/Director/Trustee Five

RACHEL THOMPSON
BOARD MEMBER
6900 ROOSEVELT RD
OAK PARK IL 60304

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/4/2015
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - 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 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
Signature Title
Signature Date

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