FORM 1023-EZ for GRIND 180 DOMINION MENTORSHIP INC

Field Data
EIN 45-5491283
Case Number EO-2015100-000309
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name GRIND 180 DOMINION MENTORSHIP INC
Organization’s Mailing Address 2758 US HWY 34 STE B177
City OSWEGO
State IL
ZIP 60543-8301
Accounting period End 6
Primary contact name DAVID CHACON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DAVID CHACON
PRESIDENT
2758 US HWY 34 STE B177
OSWEGO IL 60543-8301

Officer/Director/Trustee Two

SUZANA CHACON
SECRETARY
2758 US HWY 34 STE B177
OSWEGO IL 60543-8301

Officer/Director/Trustee Three

RICK JUMPA
TREASURER
5305 HOWARD AVE
WESTERN SPRINGS IL 60558

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/14/2012
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O99 - Youth Development N.E.C.
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: Yes
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee No
Donation of funds Yes
Conducting Activities Outside of United States Yes
Financial transactions with officers Yes
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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