FORM 1023-EZ for LA SERRANO CANCER FOUNDATION

Field Data
EIN 47-4676695
Case Number EO-2015216-000237
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LA SERRANO CANCER FOUNDATION
Organization’s Mailing Address 5905 LUCERNE LN
City LK IN THE HLS
State IL
ZIP 60156-6746
Accounting period End 12
Primary contact name GLENDA CARDENAS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

GLENDA CARDENAS
PRESIDENT
5905 LUCERNE LN
LK IN THE HLS IL 60156-6746

Officer/Director/Trustee Two

LARRY VANSIKEL
VICE PRESIDENT
1340 E LAS PALMERITAS DR
PHOENIX AZ 08520

Officer/Director/Trustee Three

CARLOS CARDENAS
TREASURER
5905 LUCERNE LN
LK IN THE HLS IL 60156-6746

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/30/2015
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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 Yes
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity Yes
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
Signature Title
Signature Date

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