FORM 1023-EZ for CROSSROADS YOUTH CENTER INC

Field Data
EIN 47-4594678
Case Number EO-2015236-000108
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CROSSROADS YOUTH CENTER INC
Organization’s Mailing Address PO BOX 54
City MILFORD
State IL
ZIP 60953
Accounting period End 6
Primary contact name TONY E WILLIAMS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

HARLAN ZIEBART
PRESIDENT
2876 E 500 N RD
WELLINGTON IL 60973

Officer/Director/Trustee Two

TONY WILLIAMS
VICE PRESIDENT
408 E WALNUT ST
WATSEKA IL 60970

Officer/Director/Trustee Three

CONNIE VANHOVLEN
TREASURY
307 W LINCOLN
IROQUOIS IL 60945

Officer/Director/Trustee Four

MARCIE SHERIDAN
DIRECTOR
635 N 2250 E ROAD
MILFORD IL 60953

Officer/Director/Trustee Five

JOY WILLIAMS
DIRECTOR
280 S 6TH ST
SHELDON IL 60966

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/29/2015
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O20 - Youth Centers, Clubs, Multipurpose
Organization’s purpose Charitable: No
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
Signature Title
Signature Date

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