FORM 1023-EZ for TEAM KAREN FOUNDATION

Field Data
EIN 82-4467514
Case Number EO-2018113-000609
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name TEAM KAREN FOUNDATION
Organization’s Mailing Address 1525 KAUTZ ROAD STE 1000
City WEST CHICAGO
State IL
ZIP 60185
Accounting period End 12
Primary contact name PETER J MESSINA JR EA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KENNETH CARLQUIST
PRESIDENT
153 NORTH PLEASANT AVENUE
BLOOMINGDALE IL 60108

Officer/Director/Trustee Two

DEREK HENLEY
VICE PRESIDENT
500 OVALTINE COURT -512
VILLA PARK IL 60181

Officer/Director/Trustee Three

PETER MESSINA JR
OFFICER
1525 KAUTZ ROAD SUITE 1000
WEST CHICAGO IL 60185

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/13/18
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E12 - Fund Raising and/or Fund Distribution
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 Yes
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 PETER MESSINA JR
Signature Title OFFICER
Signature Date 4/20/18

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