FORM 1023-EZ for MYLAH MEDICAL FOUNDATION

Field Data
EIN 82-1735387
Case Number EO-2017156-000341
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MYLAH MEDICAL FOUNDATION
Organization’s Mailing Address 4436 N SPAULDING
City CHICAGO
State IL
ZIP 60625
Accounting period End 12
Primary contact name ALICIA BOEMI
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ALICIA BOEMI
PRESIDENT
4436 N SPAULDING AVE
CHICAGO IL 60625

Officer/Director/Trustee Two

JEFF DANIEL
TREASURER
4436 N SPAULDING AVE
CHICAGO IL 60625

Officer/Director/Trustee Three

MEGAN BOEMI
SECRETARY
5333 LIKINI ST APT 2110
HONOLULU HI 96818

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/2/2017
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D20 - Animal Protection and Welfare
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
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 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 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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