FORM 1023-EZ for ADONIS QUALITY LIFE INITIATIVE

Field Data
EIN 47-3240567
Case Number EO-2015062-000200
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ADONIS QUALITY LIFE INITIATIVE
Organization’s Mailing Address 1313 S SIBLEY BLVD SUITE 104
City DOLTON
State IL
ZIP 60419
Accounting period End 12
Primary contact name CHARMAINE CARGILL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JAMES ADEMIJU
EXECUTIVE DIRECTOR
15008 S WOODLAWN
DOLTON IL 60419

Officer/Director/Trustee Two

ESTHER ADEMIJU
SECRETARY
15008 S WOODLAWN
DOLTON IL 60419

Officer/Director/Trustee Three

SONIA OLIDJE
DIRECTOR
5801 AMLIN TERRACE
MATTESON IL 60443

Organization’s website WWW.ADONISINITIATIVE.ORG
Organization’s email INFO@ADONISINITIATIVE.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/20/2015
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P99 - Human Services - Multipurpose and Other N.E.C.
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 Yes
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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