FORM 1023-EZ for IMPACT NORTHBROOK NFP

Field Data
EIN 84-2336547
Case Number EO-2019210-000245
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name IMPACT NORTHBROOK NFP
Organization’s Mailing Address 2241 CATHERINE ST
City NORTHBROOK
State IL
ZIP 60062
Accounting period End 12
Primary contact name JENNIFER KENNY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JENNIFER KENNY
DIRECTOR
2241 CATHERINE ST
NORTHBROOK IL 60062

Officer/Director/Trustee Two

ELISE MYERS
DIRECTOR
960 HAWTHORNE LN
NORTHBROOK IL 60062

Officer/Director/Trustee Three

BRIAN BROWN
DIRECTOR
1168 GREENBRIAR LN
NORTHBROOK IL 60062

Officer/Director/Trustee Four

SARAH SAMSON
DIRECTOR
2207 WALTERS AVE
NORTHBROOK IL 60062

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/5/19
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P12 - Fund Raising and/or Fund Distribution
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
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 JENNIFER KENNY
Signature Title DIRECTOR
Signature Date 7/25/19

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