FORM 1023-EZ for NICOLE CARES FOUNDATION INC

Field Data
EIN 82-1087255
Case Number EO-2017142-000426
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name NICOLE CARES FOUNDATION INC
Organization’s Mailing Address 20270 PROVIDENCE LANE
City LYNWOOD
State IL
ZIP 60411
Accounting period End 12
Primary contact name NICOLE BULLOCK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

NICOLE BULLOCK
PRESIDENT AND FOUNDER
20270 PROVIDENCE LN
LYNWOOD IL 60411

Officer/Director/Trustee Two

JAMES BULLOCK
VICE PRESIDENT AND TREASURER
20270 PROVIDENCE LN
LYNWOOD IL 60411

Officer/Director/Trustee Three

LOLITA SMITH
SECRETARY
1217 S MIAMI
MARSHALL MO 65340

Officer/Director/Trustee Four

THERESA RAYFORD
DIRECTOR
303 SENECA ST
PARK FOREST IL 60460

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/28/2017
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G30 - Cancer
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 Yes
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 No
Disaster relief assistance No
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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