FORM 1023-EZ for BLACK BELTS CARE LTD

Field Data
EIN 83-4619628
Case Number EO-2019126-000592
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BLACK BELTS CARE LTD
Organization’s Mailing Address 38W553 N LAKEVIEW CIRCLE
City SAINT CHARLES
State IL
ZIP 60175
Accounting period End 12
Primary contact name JOE SOMMER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOSEPH T SOMMER
DIRECTOR
38W553 N LAKEVIEW CIRCLE
SAINT CHARLES IL 60175

Officer/Director/Trustee Two

LISA M SOMMER
DIRECTOR
38W553 N LAKEVIEW CIRCLE
SAINT CHARLES IL 60175

Officer/Director/Trustee Three

JOHN T SOMMER
DIRECTOR
38W553 N LAKEVIEW CIRCLE
SAINT CHARLES IL 60175

Officer/Director/Trustee Four

ROBERT D SOMMER
DIRECTOR
38W553 N LAKEVIEW CIRCLE
SAINT CHARLES IL 60175

Organization’s website WWW.BLACKBELTS-CARE.COM
Organization’s email JTSOMMER@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/28/18
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 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 JOSEPH T SOMMER
Signature Title DIRECTOR
Signature Date 5/3/19

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