FORM 1023-EZ for LIFE QUILT FOUNDATION

Field Data
EIN 27-3621437
Case Number EO-2015106-000229
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LIFE QUILT FOUNDATION
Organization’s Mailing Address 2241 CHADWICK WAY
City MUNDELEIN
State IL
ZIP 60060-5380
Accounting period End 12
Primary contact name KIM B HOLMES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

KIM HOLMES
DIRECTOR
2241 CHADWICK WAY
MUNDELEIN IL 60060-5380

Officer/Director/Trustee Two

KRAIG JOHNSON
BOARD CHAIR
15356 6TH AVE
PHOENIX IL 60426-2629

Officer/Director/Trustee Three

CASSANDRA KACZOCHA
SECRETARY
6701 ROCKWELL
CHICAGO IL 60645-4625

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/27/2010
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service 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 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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