FORM 1023-EZ for LEAP SYNERGIES INC

Field Data
EIN 47-3778637
Case Number EO-2015183-000276
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LEAP SYNERGIES INC
Organization’s Mailing Address 616 MANOR LN
City MILLSTADT
State IL
ZIP 62260
Accounting period End 12
Primary contact name AUDREY MOYER-HARRIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

AUDREY MOYER-HARRIS
EXECUTIVE DIRECTOR
616 MANOR LN
MILLSTADT IL 62260

Officer/Director/Trustee Two

MICHAEL AUSTRIN
DIRECTOR OF STRATEGIC PLANNING
616 MANOR LN
MILLSTADT IL 62260

Officer/Director/Trustee Three

MARGE GROOM
DIRECTOR OF CLINICAL OPERATIONS
616 MANOR LN
MILLSTADT IL 62260

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/21/2015
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E70 - Public Health Program (Includes General Health and Wellness Promotion Services)
Organization’s purpose Charitable: No
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 Yes
One Third Support Gifts No
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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