FORM 1023-EZ for REHAB FOR DIGNITY INC

Field Data
EIN 47-2286174
Case Number EO-2015070-000884
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name REHAB FOR DIGNITY INC
Organization’s Mailing Address 121 EAST FIRST STREET
City DIXON
State IL
ZIP 61021
Accounting period End 12
Primary contact name LINDA A GIESEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

LINDA GIESEN
SECRETARY
203 EAST FELLOWS
DIXON IL 61021

Officer/Director/Trustee Two

BARBARA HERMES
DIRECTOR
2135 WHITETAIL LANE
DIXON IL 61021

Officer/Director/Trustee Three

THOMAS LAWLESS
PRESIDENT
7991 WEST BORDEAUX DRIVE
DIXON IL 61021

Officer/Director/Trustee Four

JIM GROT
TREASURER
2240 SPANGLER COURT
DIXON IL 61021

Officer/Director/Trustee Five

JOHN WEITZEL
VICE PRESIDENT
1326 SOUTH PEORIA AVENUE
DIXON IL 61021

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/23/2014
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code L81 - Home Improvement and Repairs
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 No
One Third Support Gifts Yes
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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