FORM 1023-EZ for MOBILE RECESS CLINIC CORPORATION

Field Data
EIN 83-3806804
Case Number EO-2019108-000283
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MOBILE RECESS CLINIC CORPORATION
Organization’s Mailing Address 717 W 50TH STREET 2ND FLOOR
City CHICAGO
State IL
ZIP 60609-5110
Accounting period End 12
Primary contact name NICOLE CLAUDE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

NICOLE CLAUDE
DIRECTOR/FOUNDER/CEO/TREASURER
717 W 50TH STREET 2ND FLOOR
CHICAGO IL 60609-5110

Officer/Director/Trustee Two

SHARON WILLIAMS
DIRECTOR/SECRETARY
5214 S WOODLAWN AVE
CHICAGO IL 60615

Officer/Director/Trustee Three

MARY MARYLAND
DIRECTOR
420 S HOME AVE
OAK PARK IL 60302

Organization’s website
Organization’s email NICOLECLAUDE1323@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/29/19
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E32 - Ambulatory Health Center, Community Clinic
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: Yes
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee Yes
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name NICOLE CLAUDE
Signature Title DIRECTOR/FOUNDER/CEO/TREASURER
Signature Date 4/16/19

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