FORM 1023-EZ for EXSSA CHICAGO
| Field | Data |
|---|---|
| EIN | 84-3212220 |
| Case Number | EO-2020118-000362 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | EXSSA CHICAGO |
| Organization’s Mailing Address | 158 WEDGEWOOD WAY |
| City | BOLINGBROOK |
| State | IL |
| ZIP | 60440 |
| Accounting period End | 12 |
| Primary contact name | JULIETTE NGOLLO |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
JULIETTE NGOLLO
PRESIDENT, DIRECTOR
158 WEDGEWOOD WAY
BOLINGBROOK IL 60440
Officer/Director/Trustee Two
QUINTA UTERMEYER
TREASURER, DIRECTOR
825 WEDGEWOOD COURT
LINDENHURST IL 60046
Officer/Director/Trustee Three
GABRIELLA UMENEI
SECRETARY, DIRECTOR
2631 CONNOLLY LN
WEST DUNDEE IL 60118
| Organization’s website | N/A |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 1/10/2020 |
| 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: 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 | Yes |
| 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 | JULIETTE NGOLLO |
| Signature Title | PRESIDENT, DIRECTOR |
| Signature Date | 4/24/2020 |
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