FORM 1023-EZ for VISION REHAB SPECIALISTS NFP

Field Data
EIN 83-3153165
Case Number EO-2019044-000246
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name VISION REHAB SPECIALISTS NFP
Organization’s Mailing Address 408 N RIVER GLEN AVENUE
City ELMHURST
State IL
ZIP 60126
Accounting period End 12
Primary contact name JAMES C PROVENZA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DEBRA MOREY
PRESIDENT/DIRECTOR
408 N RIVER GLEN AVENUE
ELMHURST IL 60126

Officer/Director/Trustee Two

STEVE HARRIS
DIRECTOR/TREASURER
1945 N COUNTY ROAD 2250
CARTHAGE IL 62321

Officer/Director/Trustee Three

ERIN LIPKA
DIRECTOR/SECRETARY
345 S EDSON
LOMBARD IL 60148

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/20/18
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G41 - Eye Diseases, Blindness and Vision Impairments
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 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 DEBRA MOREY
Signature Title PRESIDENT/DIRECTOR
Signature Date 2/11/19

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