FORM 1023-EZ for SHAWNEE CHAPTER

Field Data
EIN 90-0192957
Case Number EO-2021105-000361
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SHAWNEE CHAPTER
Organization’s Mailing Address PO BOX 26
City SIMPSON
State IL
ZIP 62985
Accounting period End 12
Primary contact name VICKI SIMONS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DWIGHT PRAY
CHAIRMAN
320 CARRIER MILLS RD
HARRISBURG IL 62946

Officer/Director/Trustee Two

CRICKET SIMONS
VICE CHAIRMAN
PO BOX 14
EDDYVILLE IL 62928

Officer/Director/Trustee Three

GLORIA HEGGY
SECRETARY
68 DUTTON CHAPEL RD
GOLCONDA IL 62938

Officer/Director/Trustee Four

VICKI SIMONS
TREASURER
PO BOX 14
EDDYVILLE IL 62928

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/27/2002
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B01 - Alliance/Advocacy Organizations
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name VICKI SIMONS
Signature Title TREASURER
Signature Date 4/13/2021

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