FORM 1023-EZ for DJS LENS INC

Field Data
EIN 83-0539499
Case Number EO-2018179-000369
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name DJS LENS INC
Organization’s Mailing Address 521 E 91ST STREET
City CHICAGO
State IL
ZIP 60619
Accounting period End 12
Primary contact name ARIELLE SMITH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ARIELLE SMITH
CHIEF EXECUTIVE OFFICER
1136 E 101ST STREET
CHICAGO IL 60628-7609

Officer/Director/Trustee Two

DEONTE SMITH
CHIEF OPERATING OFFICER
4852 S WINCHESTER
CHICAGO IL 60609-4166

Officer/Director/Trustee Three

FELIX BARNES
CHIEF FINANCIAL OFFICER
6115 OLD PLANK BLVD
MATTESON IL 60443-1696

Officer/Director/Trustee Four

REGINALD WALTON
CHAIRPERSON OF THE GOVERNING BODY
521 E 91ST STREET
CHICAGO IL 60619-7428

Officer/Director/Trustee Five

LASHONE BARKSDALE-JONES
BOARD MEMBER
376 E 89TH STREET
CHICAGO IL 60619-6748

Organization’s website WWW.DJSLENS.ORG
Organization’s email OURDJSLENS@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/6/18
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B01 - Alliance/Advocacy Organizations
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 ARIELLE SMITH
Signature Title CHIEF EXECUTIVE OFFICER
Signature Date 6/26/18

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