FORM 1023-EZ for SENIOR SHARED HOMES

Field Data
EIN 83-3346103
Case Number EO-2019105-000270
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SENIOR SHARED HOMES
Organization’s Mailing Address 752 SADDLE RIDGE
City CRYSTAL LAKE
State IL
ZIP 60012-3608
Accounting period End 12
Primary contact name CHARLES BENISH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CHARLES BENISH
CHIEF FINANICAL OFFICER
2607 W MANITOU TRL
MCHENRY IL 60051-9648

Officer/Director/Trustee Two

THERESE RUBINO GOERDT
PRESIDENT
752 SADDLE RIDGE
CRYSTAL LAKE IL 60012-3608

Officer/Director/Trustee Three

ARTHUR HICKMAN
DIRECTOR
2113 N MELVINA AVE
CHICAGO IL 60639-2601

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/29/19
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code L22 - Senior Citizens' Housing/Retirement Communities
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 Yes
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance No
One Third Support Public No
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name CHARLES BENISH
Signature Title CHEIF FINANICAL OFFICER
Signature Date 4/11/19

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