FORM 1023-EZ for CSL FOUNDATION

Field Data
EIN 84-2640878
Case Number EO-2019259-000592
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CSL FOUNDATION
Organization’s Mailing Address 1702 SUNSET DRIVE
City MENDOTA
State IL
ZIP 61342
Accounting period End 12
Primary contact name REBECCA MCPHEETERS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

REBECCA MCPHEETERS
CHIEF OFFICER
1702 SUNSET DRIVE
MENDOTA IL 61342

Officer/Director/Trustee Two

DAVID LILJA
OFFICER
3144 COTTAGE HILL ROAD
PAW PAW IL 61353

Officer/Director/Trustee Three

DEBORAH BODMER
OFFICER
177 E US HWY 52
MENDOTA IL 61342

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/6/19
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code K28 - Farm Bureau, Grange
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 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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name REBECCA MCPHEETERS
Signature Title CHIEF OFFICER
Signature Date 9/11/19

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