FORM 1023-EZ for GO GREEN FOR VITALITY

Field Data
EIN 47-5175030
Case Number EO-2015280-000328
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name GO GREEN FOR VITALITY
Organization’s Mailing Address 12526 S LOOMIS
City CALUMET PARK
State IL
ZIP 60827
Accounting period End 12
Primary contact name HYACINTH GARDNER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

HYACINTH GARDNER
PRSIDENT
12526 S LOOMIS
CHICAGO IL 60827

Officer/Director/Trustee Two

SAID NOUR
VICE PRESIDENT
1901 S CANAL
BLUE ISLAND IL 60406

Officer/Director/Trustee Three

TONY LYONS
SECRETARY
7203 ONTARIO AVE
HAMMOND IL 46323

Officer/Director/Trustee Four

NATHAN KIRKWOOD
FINANCIAL OVERSIGHT
1942 E 79TH STREET
CHICAGO IL 60649

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/14/2014
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code K40 - Nutrition Programs
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 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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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