FORM 1023-EZ for TWELVE BASKETS FULL INC
| Field | Data |
|---|---|
| EIN | 45-3702595 |
| Case Number | EO-2015322-000348 |
| Form 1023-EZ version | 62014 |
| Eligibility Worksheet | 1 |
| Organization Name | TWELVE BASKETS FULL INC |
| Organization’s Mailing Address | 6309 WIND TREE ROAD |
| City | SPRINGFIELD |
| State | IL |
| ZIP | 62712 |
| Accounting period End | 12 |
| Primary contact name | RODERICK L MATTICKS |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $400.00 |
Officer/Director/Trustee One
RODERICK MATTICKS
PRESIDENT AND CEO
6309 WIND TREE ROAD
S IL 62712
Officer/Director/Trustee Two
DONNA MATTICKS
SECRETARY
6309 WIND TREE ROAD
S IL 62712
Officer/Director/Trustee Three
RICHARD CHIOLA
VP MISSION INTEGRATION
2926 VICTORIA DR
SPRINGFIELD IL 62704
Officer/Director/Trustee Four
ANDREW ROSEBOOM
VP PHARMACY SERVICES
201 FREEDOM TRAIL
EAST PEORIA IL 61611
Officer/Director/Trustee Five
THOMAS HASSEN
VP, TREASURER
331 SUNSET BEACH ROAD
MORGANTOWN WV 26508
| Organization’s website | WWW.12BASKETSFULL.ORG |
|---|---|
| Organization’s email | RMATTICKS@12BASKETSFULL.ORG |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 10/17/2011 |
| Organization Incorporation State | IL |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | E60 - Health Support Services |
| 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 | Yes |
| Unrelated Gross Income $1,000 or More | No |
| Gaming Activity | No |
| Disaster relief assistance | No |
| One Third Support Public | No |
| One Third Support Gifts | Yes |
| Benefit of College | No |
| Private Foundation 508(e) | No |
| Seeking Retroactive Reinstatement | Yes |
| Seeking Section 7 Reinstatement | No |
| Correctness Declaration | Yes |
| Signature Name | |
| Signature Title | |
| Signature Date |
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