FORM 1023-EZ for THE CLIFTON P LEWIS FOUNDATION

Field Data
EIN 36-4847526
Case Number EO-2020021-000358
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name THE CLIFTON P LEWIS FOUNDATION
Organization’s Mailing Address PO BOX 8222
City WESTCHESTER
State IL
ZIP 60154
Accounting period End 12
Primary contact name TAMARA TUCKER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TAMARA TUCKER
DIRECTOR
2ND FLOOR
CHICAGO IL 60651

Officer/Director/Trustee Two

JEROME MAYS
INUSRANCE LIASION
9315 S EAST END AVE
CHICAGO IL 60647

Officer/Director/Trustee Three

KEYONTA THOMAS
EDUCATION LIASION
938 N WALLER AVE
CHICAGO IL 60651

Officer/Director/Trustee Four

DERRIUS DANIELS
BUSINESS LIASION
118 N KEELER AVE
CHICAGO IL 60624

Officer/Director/Trustee Five

TONNETTE JONES
COMMUNITY RELATION LIASION
6939 S WOLCOTT
CHICAGO IL 60636

Organization’s website
Organization’s email CLIFTONPLEWISFOUNDATION@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/1/2017
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Z99 - Unclassified
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 No
One Third Support Public No
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name TAMARA TUCKER
Signature Title DIRECTOR
Signature Date 1/16/2020

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