FORM 1023-EZ for ANNMARIE FOUNDATION NFP

Field Data
EIN 46-4532708
Case Number EO-2015141-000364
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ANNMARIE FOUNDATION NFP
Organization’s Mailing Address 11803 BROOK HILL COURT
City ORLAND PARK
State IL
ZIP 60467
Accounting period End 11
Primary contact name KEVIN L STERK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

SUSAN BLAHA
PRESIDENT
11803 BROOK HILL CT
ORLAND PARK IL 60467

Officer/Director/Trustee Two

MICHAEL BLAHA
TRUSTEE
11803 BROOK HILL CT
ORLAND PARK IL 60467

Officer/Director/Trustee Three

COLLEEN FILMANOWICZ
SECRETARY
17646 CRESTVIEW COURT
ORLAND PARK IL 60467

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/14/2014
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F80 - Mental Health Association, Multipurpose
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 Yes
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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