FORM 1023-EZ for GRASSROOTS ENGAGEMENT AND ACTION FOR ROCKFORD

Field Data
EIN 47-5217214
Case Number EO-2015306-000296
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name GRASSROOTS ENGAGEMENT AND ACTION FOR ROCKFORD
Organization’s Mailing Address 1829 N ROCKTON AVE
City ROCKFORD
State IL
ZIP 61103-4367
Accounting period End 12
Primary contact name ERIC LEMONHOLM
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ELLYN AHMER
PRESIDENT
1535 E STATE ST
ROCKFORD IL 61104

Officer/Director/Trustee Two

BOB HILLENBRAND
VICE-PRESIDENT
1239 N GARRISON
ROCKFORD IL 61103

Officer/Director/Trustee Three

ERIC LEMONHOLM
TREASURER
2111 CLINTON ST
ROCKFORD IL 61103

Officer/Director/Trustee Four

PAM HILLENBRAND
SECRETERY
1239 N GARRISON
ROCKFORD IL 61103

Officer/Director/Trustee Five

KEITH KELSEY-POWELL
BOARD MEMBER
6555 WEAVER RD
ROCKFORD IL 61114-8002

Organization’s website WWW.GEAR-ROCKFORD.ORG
Organization’s email LEMONHOLM@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/2/2015
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code R01 - Alliance/Advocacy Organizations
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
Signature Title
Signature Date

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