FORM 1023-EZ for NATIONAL CAMBODIAN HERITAGE MUSEUMAND KILLING FIELDS MEMORIAL

Field Data
EIN 47-4219699
Case Number EO-2015175-000319
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name NATIONAL CAMBODIAN HERITAGE MUSEUMAND KILLING FIELDS MEMORIAL
Organization’s Mailing Address 2831 W LAWRENCE AVE
City CHICAGO
State IL
ZIP 60625-3619
Accounting period End 6
Primary contact name KOMPHA SETH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

SOPHOAN JEFF LOEUNG
PRESIDENT
710 E HACKBERRY LANE
MT. PROSPECT IL 60056-1310

Officer/Director/Trustee Two

PAUL CHHORM
VICE PRESIDENT
881 WALTER AVE
DES PLAINES IL 60090-3230

Officer/Director/Trustee Three

CHOU SITH
TREASURER
4634 N MONTICELLO AVE
CHICAGO IL 60625-3619

Officer/Director/Trustee Four

NEN SOK
BOARD MEMBER
2632 W RASHER AVE
CHICAGO IL 60625-3619

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/27/2015
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A20 - Arts, Cultural Organizations - Multipurpose
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 Yes
One Third Support Public No
One Third Support Gifts No
Benefit of College Yes
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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