FORM 1023-EZ for AYAGENS FOUNDATION

Field Data
EIN 86-3022067
Case Number EO-2021140-000301
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name AYAGENS FOUNDATION
Organization’s Mailing Address 1906 N WOODLAWN PARK AVE
City MCHENRY
State IL
ZIP 60051
Accounting period End 12
Primary contact name DANIEL COTTER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MICHAEL WERNER
PRESIDENT
1906 N WOODLAWN PARK AVE
MCHENRY IL 60051

Officer/Director/Trustee Two

DEBRA WERNER
TREASURER
1906 N WOODLAWN PARK AVE
MCHENRY IL 60051

Officer/Director/Trustee Three

BRUCE SPECHT
SECRETARY
19 HICKORY TRAIL
GALENA IL 61036

Organization’s website WWW.AYAGENS.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/31/2021
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G30 - Cancer
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
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 MICHAEL WERNER
Signature Title PRESIDENT
Signature Date 5/18/2021

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