FORM 1023-EZ for OPTOMETRIC GLAUCOMA FOUNDATION

Field Data
EIN 46-4701816
Case Number EO-2017325-000185
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name OPTOMETRIC GLAUCOMA FOUNDATION
Organization’s Mailing Address 2328 W CHARLESTON STREET
City CHICAGO
State IL
ZIP 60647
Accounting period End 12
Primary contact name KELLIE ROBERTSON ROGERS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KELLIE ROBERTSON ROGERS
EXECUTIVE DIRECTOR
2828 W CHARLESTON STREET
CHICAGO IL 60647

Officer/Director/Trustee Two

MURRAY FINGERET
PRESIDENT
183 LAKEVIEW DRIVE
HEWLETT NY 11557

Officer/Director/Trustee Three

LEO SEMES
VICE-PRESIDENT
216 PABLO COURT
POINT VEDRO BEACH FL 32082

Officer/Director/Trustee Four

JOHN MCSOLEY
SECRETARY
4901 TYLER STREET
HOLLYWOOD FL 33021

Officer/Director/Trustee Five

AUSTIN LIFFERTH
TREASURER
1208 NE 51ST CIRCLE
OXFORD FL 34484

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/24/2014
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G41 - Eye Diseases, Blindness and Vision Impairments
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
Scientific: Yes
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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