FORM 1023-EZ for SAMS SWEET HEART MEMORIAL FOUNDATION

Field Data
EIN 82-4489120
Case Number EO-2018060-000119
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SAMS SWEET HEART MEMORIAL FOUNDATION
Organization’s Mailing Address 304 CALVIN PARK SOUTH
City ROCKFORD
State IL
ZIP 61108
Accounting period End 12
Primary contact name ALISSA BARTEL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ALISSA BARTEL
PRESIDENT
304 CALVIN PARK SOUTH
ROCKFORD IL 61108

Officer/Director/Trustee Two

LUKE BARTEL
FOUNDER, VICE PRESIDENT
304 CALVIN PARK SOUTH
ROCKFORD IL 61108

Officer/Director/Trustee Three

ASHLEY ROGERS
SECRETARY
1842 BALMORAL CT
BELVIDERE IL 61008

Officer/Director/Trustee Four

KYLE ROGERS
TREASURER
1842 BALMORAL CT
BELVIDERE IL 61008-8711

Officer/Director/Trustee Five

COURTNEY GEIGER
CHAIR OF THE BOARD OF DIRECTORS
3424 MINNESOTA DRIVE
ROCKFORD IL 61108

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/17/18
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E86 - Patient Services - Entertainment, Recreation
Organization’s purpose Charitable: Yes
Religious: No
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 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 ALISSA BARTEL
Signature Title PRESIDENT
Signature Date 2/27/18

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