FORM 1023-EZ for REHOBOTH HOLISTIC COMMUNITY CENTER

Field Data
EIN 46-5111654
Case Number EO-2015002-000287
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name REHOBOTH HOLISTIC COMMUNITY CENTER
Organization’s Mailing Address 12245 S PERRY AVE
City CHICAGO
State IL
ZIP 60628-6826
Accounting period End 12
Primary contact name ROSE PARKER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ROSE PARKER
PRESIDENT
12245 S PERRY AVE
CHICAGO IL 60628-6826

Officer/Director/Trustee Two

DALE KELLEY
TREASURER
1340 S INDIANA PARKWAY
CHICAGO IL 60605-2168

Officer/Director/Trustee Three

TERRI JOHNSON
DIRECTOR
8315 S THROOP
CHICAGO IL 60652-3633

Officer/Director/Trustee Four

KAREN COLE
SECRETARY
2936 W ADAMS
CHICAGO IL 60612-3604

Officer/Director/Trustee Five

CONNIE BUGG
DIRECTOR
6643 S GREENWOOD AVE
CHICAGO IL 60637-4334

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/5/2014
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
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
Signature Title
Signature Date

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