FORM 1023-EZ for URSA ENSEMBLE

Field Data
EIN 46-5369889
Case Number EO-2016076-000221
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name URSA ENSEMBLE
Organization’s Mailing Address 5516 N KENMORE AVE APT 202
City CHICAGO
State IL
ZIP 60640-1536
Accounting period End 6
Primary contact name LAURA ADKINS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

RACHEL BROWN
PRESIDENT
5516 N KENMORE AVE APT 202
CHICAGO IL 60640-1536

Officer/Director/Trustee Two

NICHOLAS JEFFREY
SECRETARY-TREASURER
320 WISCONSIN AVE APT 314
OAK PARK IL 60302-3457

Officer/Director/Trustee Three

JONATHAN HANNAU
MEMBER-AT-LARGE
959 W WEBSTER AVE APT 3B
CHICAGO IL 60614-3644

Organization’s website WWW.URSAENSEMBLE.COM
Organization’s email URSAENSEMBLE@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/19/2014
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A68 - Music
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 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 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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