FORM 1023-EZ for JIVA

Field Data
EIN 84-3195775
Case Number EO-2019275-000070
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name JIVA
Organization’s Mailing Address 1133 E 83RD ST UNIT 208
City CHICAGO
State IL
ZIP 60619
Accounting period End 6
Primary contact name PHILANA TAYLOR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PHILANA L TAYLOR
PRESIDENT
1133 E 83RD ST UNIT 208
CHICAGO IL 60619

Officer/Director/Trustee Two

TABATHA HAYNES
DIRECTOR
4311 W 186TH PLACE
COUNTRY CLUB HILLS IL 60478

Officer/Director/Trustee Three

JIM ALLEN
DIRECTOR
1133 E 83RD ST UNIT
CHICAGO IL 60619

Organization’s website
Organization’s email JIVECHICAGO@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/24/19
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N01 - Alliance/Advocacy Organizations
Organization’s purpose Charitable: Yes
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 PHILANA L TAYLOR
Signature Title PRESIDENT
Signature Date 9/28/19

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