FORM 1023-EZ for SOUL SURVIVOR FOUNDATION

Field Data
EIN 82-4986097
Case Number EO-2019059-000378
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SOUL SURVIVOR FOUNDATION
Organization’s Mailing Address 3110 E 79TH STREET
City CHICAGO
State IL
ZIP 60649
Accounting period End 12
Primary contact name JONATHAN FORD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JONATHAN FORD
EXECUTIVE DIRECTOR/TREASURER
8825 SOUTH CALUMET AVENUE
CHICAGO IL 60619

Officer/Director/Trustee Two

ERIN KELLEY AUSTIN
SECRETARY
12316 SOUTH EMERALD AVENUE
CHICAGO IL 60628

Officer/Director/Trustee Three

JASON OLIVER
TRUSTEE
1549 EUCLID AVENUE
CHICAGO HEIGHTS IL 60411

Officer/Director/Trustee Four

SEAN WILLIAMS
DIRECTOR
3057 E CHELTENHAM PLACE
CHICAGO IL 60649

Officer/Director/Trustee Five

JASMYN FORD
DIRECTOR
6734 OHIO AVENUE
HAMMOND IN 46323

Organization’s website N/A
Organization’s email SOULSURVIVORNFP@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/27/18
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
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 JONATHAN FORD
Signature Title TREASURER
Signature Date 2/26/19

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