FORM 1023-EZ for ROBERT L AND ANNA C BLISS FOUNDATION FOR THE ARTS

Field Data
EIN 84-2578537
Case Number EO-2019217-000125
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ROBERT L AND ANNA C BLISS FOUNDATION FOR THE ARTS
Organization’s Mailing Address 2624 PARK PLACE
City EVANSTON
State IL
ZIP 60201-1318
Accounting period End 12
Primary contact name HELEN D BREST VAN KEMPEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

HELEN BREST VAN KEMPEN
DIRECTOR
2624 PARK PL
EVANSTON IL 60201-1318

Officer/Director/Trustee Two

GUSTAAF BREST VAN KEMPEN
DIRECTOR
2624 PARK PLACE
EVANSTON IL 60201-1318

Officer/Director/Trustee Three

HOWARD SMITH
DIRECTOR
374 W 400 N
SALT LAKE CITY UT 84103

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/30/18
Organization Incorporation State UT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A20 - Arts, Cultural Organizations - Multipurpose
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: Yes
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 No
Disaster relief assistance No
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 HELEN BREST VAN KEMPEN
Signature Title DIRECTOR
Signature Date 7/31/19

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