FORM 1023-EZ for BETHEL FAMILY RESOURCE CENTER

Field Data
EIN 47-3794038
Case Number EO-2018282-000242
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BETHEL FAMILY RESOURCE CENTER
Organization’s Mailing Address 1250 PORTLAND AVENUE
City CHICAGO HEIGHTS
State IL
ZIP 60411-2800
Accounting period End 12
Primary contact name LAWRENCE J BLACKFUL JR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LULA GOLDEN
PRESIDENT
1250 PORTLAND AVENUE
CHICAGO HEIGHTS IL 60411-2800

Officer/Director/Trustee Two

SHAVON HOLMES
SECRETARY
1250 PORTLAND AVENUE
CHICAGO HEIGHTS IL 60411-2800

Officer/Director/Trustee Three

STEVEN WRIGHT
MEMBER
1250 PORTLAND AVENUE
CHICAGO HEIGHTS IL 60411-2800

Organization’s website WWW.BETHELFACILITY.ORG
Organization’s email MAIL@BETHELFACILITY.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/22/15
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name LULA GOLDEN
Signature Title PRESIDENT
Signature Date 10/4/18
EIN 47-3794038
Case Number EO-2015155-000288
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BETHEL FAMILY RESOURCE CENTER
Organization’s Mailing Address 1250 PORTLAND AVENUE
City CHICAGO HEIGHTS
State IL
ZIP 60411-2800
Accounting period End 12
Primary contact name LAWRENCE J BLACKFUL JR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

LULA GOLDEN
PRESIDENT
27605 S KUERSTEN ROAD
MONEE IL 60449-9113

Officer/Director/Trustee Two

CRAIG YODER
DIRECTOR
1522 CHALONE COURTC
CROWN POINT IN 46307

Officer/Director/Trustee Three

STEVE WRIGHT
DIRECTOR
P O BOX 472
MOKENA IL 60448

Officer/Director/Trustee Four

SHEENAH BROOKS
DIRECTOR
839 HARVARD LANE
MATTESON IL 60443

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/1/2015
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Z99 - Unclassified
Organization’s purpose Charitable: Yes
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
Signature Title
Signature Date

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