FORM 1023-EZ for VETERANS PAIN RELIEF NFP

Field Data
EIN 82-2033672
Case Number EO-2018157-000056
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name VETERANS PAIN RELIEF NFP
Organization’s Mailing Address 2410 N PEORIA AVE
City PEORIA
State IL
ZIP 61603
Accounting period End 12
Primary contact name MARTIN BELCKE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KIRK KIMMEL
PRESIDENT
2410 N PEORIA AVE
PEORIA IL 61603

Officer/Director/Trustee Two

MARTIN BELCKE
VICE PRESIDENT
2132 N WINDERNERE AVE
PEORIA IL 61604

Officer/Director/Trustee Three

DAN BAYLESS
BOARD MEMBER
2315 W FORREST HILL
PEORIA IL 61604

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/23/17
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E99 - Health - General and Rehabilitative N.E.C.
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 No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name KIRK KIMMEL
Signature Title PRESIDENT
Signature Date 6/4/18

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