FORM 1023-EZ for BUSHNELL CITIZENS COALITION

Field Data
EIN 47-5568375
Case Number EO-2015320-000383
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BUSHNELL CITIZENS COALITION
Organization’s Mailing Address 975 WASHINGTON BLVD
City BUSHNELL
State IL
ZIP 61422
Accounting period End 10
Primary contact name JODY GLYNN PATRICK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JODY PATRICK
PRESIDENT
975 WASHINGTON BLVD
BUSHNELL IL 61422-1053

Officer/Director/Trustee Two

SHANNON PRICE
TREASURER
976 WASHINGTON BLVD
BUSHNELL IL 61422-1043

Officer/Director/Trustee Three

DONALD KLINEDINST
DIRECTOR
1105 WASHINGTON BLVD
BUSHNELL IL 61422-1028

Officer/Director/Trustee Four

KEVIN PATRICK
DIRECTOR
975 WASHINGTON BLVD
BUSHNELL IL 61422-1053

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/11/2015
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S20 - Community, Neighborhood Development, Improvement (General)
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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