FORM 1023-EZ for AXEMEN IL CHAPTER 1 INC

Field Data
EIN 47-4788362
Case Number EO-2015259-000278
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name AXEMEN IL CHAPTER 1 INC
Organization’s Mailing Address 7110 W 127TH ST STE 230
City PALOS HEIGHTS
State IL
ZIP 60463-1580
Accounting period End 12
Primary contact name MARK KLESMAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

WILLIAM HUMPHREY
PRESIDENT
8652 S TRIPP AVE
CHICAGO IL 60652

Officer/Director/Trustee Two

LARRY ANOMAN
SECRETARY
10231 S WESTERN AVE
CHICAGO IL 60643

Officer/Director/Trustee Three

CHARLES TEVERBAUGH JR
TREASURER
10131 S WALLACE ST
CHICAGO IL 60625

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/12/2015
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P40 - Family Services
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 No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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