FORM 1023-EZ for GREG W ERVIN FOUNDATION

Field Data
EIN 84-2494620
Case Number EO-2019210-000259
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name GREG W ERVIN FOUNDATION
Organization’s Mailing Address 608 N OHIO STREET
City TOLEDO
State IL
ZIP 62468
Accounting period End 12
Primary contact name BARBARA J HALL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

COLE ERVIN
DIRECTOR/PRESIDENT
842 CR 1350 E
TOLEDO IL 62468

Officer/Director/Trustee Two

KYLEE ERVIN
DIRECTOR/VICE-PRESIDENT
599 HICKORY HILLS BLD
WHITES CREEK TN 37189

Officer/Director/Trustee Three

CHRISTIE ERVIN
DIRECTOR
813 CR 1350 E
TOLEDO IL 62438

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/24/19
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T22 - Private Independent Foundations
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name COLE ERVIN
Signature Title DIRECTOR/PRESIDENT
Signature Date 7/25/19

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