FORM 1023-EZ for SOUTHWEST CENTER OF POLISH SONG ANDDANCE

Field Data
EIN 82-4713477
Case Number EO-2018208-000277
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SOUTHWEST CENTER OF POLISH SONG ANDDANCE
Organization’s Mailing Address 8632 W 103RD ST STE B
City PALOS HILLS
State IL
ZIP 60465
Accounting period End 12
Primary contact name NICOLE BENCIK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

NICOLE BENCIK
PRESIDENT
8632 W 103RD ST STE B
PALOS HILLS IL 60465

Officer/Director/Trustee Two

MONICA PAZDZIORA
VICE PRESIDENT
8632 W 103RD ST STE B
PALOS HILLS IL 60465

Officer/Director/Trustee Three

IVONA JABLONSKI GAL
SECRETARY/TREASURER
8632 W 103RD ST STE B
PALOS HILLS IL 60465

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/8/17
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A6C - Music Groups, Bands, Ensembles
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 NICOLE BENCIK
Signature Title PRESIDENT
Signature Date 7/25/18

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