FORM 1023-EZ for HEALTHY GRUB RX

Field Data
EIN 85-2786605
Case Number EO-2020246-000477
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HEALTHY GRUB RX
Organization’s Mailing Address 2844 W ROOSEVELT ROAD
City CHICAGO
State IL
ZIP 60612
Accounting period End 3
Primary contact name WINSTON COCKBURN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

WINSTON COCKBURN
MANAGER
2838 W ROOSEVELT ROAD
CHICAGO IL 60612

Officer/Director/Trustee Two

SHEREE BRADLEY
TRESURER
9127 S KOMENSKY AVE
OAK LAWN IL 60453

Officer/Director/Trustee Three

PRUDENCE COCKBURN
SECRETARY
5609 MARTHONNA WAY
RALEIGH NC 27616

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/31/2020
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code K40 - Nutrition Programs
Organization’s purpose Charitable: No
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 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 WINSTON COCKBURN
Signature Title MANAGER
Signature Date 8/31/2020

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