FORM 1023-EZ for DS AWARENESS FUND

Field Data
EIN 82-2475203
Case Number EO-2017228-000252
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name DS AWARENESS FUND
Organization’s Mailing Address 109 N SHERIDAN ST
City LOSTANT
State IL
ZIP 61334
Accounting period End 12
Primary contact name JENNIFER RADTKE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TRISHA JAMISON
PRESIDENT
109 N SHERIDAN ST
LOSTANT IL 61334

Officer/Director/Trustee Two

DONEIDA LARSEN
VICE PRESIDENT
408 W 2ND STREET
LOSTANT IL 61334

Officer/Director/Trustee Three

JENNIFER RADTKE
TREASURER
2611 LAURA DR
PERU IL 61354

Officer/Director/Trustee Four

AMANDA HARTY
SECRETARY
2371 E 29TH RD
SENECA IL 61360

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/1/2017
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G54 - Epilepsy
Organization’s purpose Charitable: Yes
Religious: No
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 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
Signature Title
Signature Date

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