FORM 1023-EZ for TC-ST ANN IRREVOCABLE TRUST

Field Data
EIN 81-6171818
Case Number EO-2016007-000379
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name TC-ST ANN IRREVOCABLE TRUST
Organization’s Mailing Address 6123 MANDALAY
City PEORIA
State IL
ZIP 61614
Accounting period End 9
Primary contact name JOHN A SLEVIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JOHN A SLEVIN
SETTLOR
6123 MANDALAY
PEORIA IL 61614

Officer/Director/Trustee Two

THOMAS R WIEGAND
SETTLOR
706 BAY SIDE CIRCLE
METAMORA IL 61548

Officer/Director/Trustee Three

GERALD L REPASZ
TRUSTEE
10409 N PHEASANT LANE
PEORIA IL 61615

Officer/Director/Trustee Four

MARJORIE A REPASZ
TRUSTEE
10409 N PHEASANT LANE
PEORIA IL 61615

Organization’s website
Organization’s email
Organization Incorporated
Organization trust Yes
Necessary Organizing Documents Yes
Organization Incorporation Date 9/11/2015
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X22 - Roman Catholic
Organization’s purpose Charitable: No
Religious: Yes
Educational: No
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 Yes
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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