FORM 1023-EZ for COAL CITY BACKPACK PROGRAM

Field Data
EIN 47-1498840
Case Number EO-2016055-000128
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name COAL CITY BACKPACK PROGRAM
Organization’s Mailing Address 7855 E ARROWLEAF TRAIL
City COAL CITY
State IL
ZIP 60416
Accounting period End 12
Primary contact name CHERIE SIEGER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

CHERIE SIEGER
PRESIDENT/CHAIRMAN
7855 E ARROWLEAF TRAIL
COAL CITY IL 60416-9571

Officer/Director/Trustee Two

SARA SMITH
VP, CO-CHAIRMAN,TREASURER
1135 S BROADWAY
COAL CITY IL 60416-1805

Officer/Director/Trustee Three

PAMELA CARLTON
VP,CO-CHAIRMAN,SECRETARY
310 N FIFTH AVE
COAL CITY IL 60416

Organization’s website
Organization’s email COALCITYBACKPACK@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/1/2014
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code K30 - Food Service, Free Food Distribution Programs
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 Yes
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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