FORM 1023-EZ for CBG INSTITUTE FOR DANCE AND HEALTH INC

Field Data
EIN 82-1078231
Case Number EO-2017123-000196
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CBG INSTITUTE FOR DANCE AND HEALTH INC
Organization’s Mailing Address 1288 MC DANIELS AVE
City HIGHLAND PARK
State IL
ZIP 60035
Accounting period End 12
Primary contact name LYNNE CHERVONY BELSKY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LORRAINE CHASE
PRESIDENT
937 TIMBER HILL ROAD
HIGHLAND PARK IL 60035

Officer/Director/Trustee Two

KAREN SUS
SECRETARY
508 APPLETREE LANE
DEERFIELD IL 60015

Officer/Director/Trustee Three

GREG BEGLEY
TREASURER
441 KELBURN RD 312
DEERFIELD IL 60015

Officer/Director/Trustee Four

LYNNE CHERVONY BELSKY
DIRECTOR
1288 MC DANIELS AVE
HIGHLAND PARK IL 60035

Officer/Director/Trustee Five

LISA GOLD
DIRECTOR
1288 MC DANIELS AVE
HIGHLAND PARK IL 60035

Organization’s website
Organization’s email DANCEFORJOY16@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/24/2017
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P99 - Human Services - Multipurpose and Other N.E.C.
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 Yes
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 Yes
One Third Support Gifts No
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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