FORM 1023-EZ for RESEARCH INSTITUTE FOR VALUES BASEDLEADERSHIP

Field Data
EIN 46-4567163
Case Number EO-2015187-000416
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name RESEARCH INSTITUTE FOR VALUES BASEDLEADERSHIP
Organization’s Mailing Address 3300 SW 33RD STREET
City DES MOINES
State IA
ZIP 50321-1916
Accounting period End 12
Primary contact name PHILLIP W CAPONIGRO PHD-ABD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

PHILLIP CAPONIGRO
PRESIDENT/CEO
3300 SW 33RD STREET
DES MOINES IA 50321-1916

Officer/Director/Trustee Two

CARMEN MADIA
MEMBER BOARD OF DIRECTORS
411 SARA
LEMONT IL 60439-4550

Officer/Director/Trustee Three

FRANK MARIO
MEMBER BOARD OF DIRECTORS
838 N CLINTON
DALLAS TX 75208-3661

Officer/Director/Trustee Four

JULIE EVANS
MEMBER BOARD OF DIRECTORS
3200 PARK AVE
DES MOINES IA 50321-1442

Officer/Director/Trustee Five

MICHAEL ORTICELLI
MEMBER BOARD OF DIRECTORS
20 COVEYS WAY
SARANAC LAKE NY 12983-2526

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/5/2014
Organization Incorporation State IA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code V05 - Research Institutes and/or Public Policy Analysis
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 Yes
Donation of funds Yes
Conducting Activities Outside of United States No
Financial transactions with officers Yes
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance Yes
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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