FORM 1023-EZ for SANTA FOR SOLITARY SENIORS

Field Data
EIN 82-3318979
Case Number EO-2018045-000160
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SANTA FOR SOLITARY SENIORS
Organization’s Mailing Address 5321 GINGERIDGE LANE
City ROCKFORD
State IL
ZIP 61114
Accounting period End 12
Primary contact name STACI M HOLTHUS - ATTORNEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SCOTT OLSON
PRESIDENT/DIRECTOR
909 PARKWOOD AVENUE
ROCKFORD IL 61107

Officer/Director/Trustee Two

MARK HATCH
VICE PRESIDENT/DIRECTOR
3444 BURLWOOD DRIVE
ROCKFORD IL 61114

Officer/Director/Trustee Three

JESSICA LANGFORD AKA IASPARRO
TREASURER/DIRECTOR
5321 GINGERIDGE LANE
ROCKFORD IL 61114

Officer/Director/Trustee Four

MELISSA MINNAERT
SECRETARY/DIRECTOR
3522 BROOKVIEW ROAD
ROCKFORD IL 61107

Officer/Director/Trustee Five

LAUREN ZANELLO
DIRECTOR
12496 N PASEO PENUELA
MARANA AZ 85658

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/25/17
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P75 - Senior Continuing Care Communities
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 Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name SCOTT OLSON
Signature Title PRESIDENT/DIRECTOR
Signature Date 2/12/18

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