FORM 1023-EZ for THE LEADING BY LEGACY FOUNDATION

Field Data
EIN 47-2307238
Case Number EO-2015051-000034
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name THE LEADING BY LEGACY FOUNDATION
Organization’s Mailing Address 18860 HAMLIN AVE
City FLOSSMOOR
State IL
ZIP 60422-1046
Accounting period End 11
Primary contact name ANN WILBORN JACKSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ANN JACKSON
PRESIDENT
18860 HAMLIN AVE
FLOSSMOOR IL 60422-1046

Officer/Director/Trustee Two

KAITLIN BLOW
BORAD MEMBER
402 YATES
CALUMET CITY IL 60409-2317

Officer/Director/Trustee Three

LACHELLE WILBORN
TREASURER
203 MINT HILL DRIVE
CARY NC 27519-6104

Officer/Director/Trustee Four

BRIAN HARRISON
VICE PRESIDENT
2 LEAMONT COURT
OAKLAND CA 94605-5355

Officer/Director/Trustee Five

CRYSTAL EDWARDS
SECERATRY
7247 S CALUMET AVE
CHICAGO IL 60619-1760

Organization’s website WWW.LEGACYHEALTHCARESOLUTIONS.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/17/2014
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B80 - Student Services, Organizations of Students
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 Yes
Conducting Activities Outside of United States Yes
Financial transactions with officers No
Unrelated Gross Income $1,000 or More Yes
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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