FORM 1023-EZ for RETINA HALL OF FAME

Field Data
EIN 82-3962535
Case Number EO-2018156-000078
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name RETINA HALL OF FAME
Organization’s Mailing Address 10 W PHILLIP RD SUITE 120
City VERNON HILLS
State IL
ZIP 60061-1730
Accounting period End 12
Primary contact name RICHARD PAUL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ZVETAN ZAKOV
SECRETARY-TREASURER
336 OVERLOOK BROOK DR
CHAGRIN FALLS OH 44023-6712

Officer/Director/Trustee Two

MARK HUMAYUN
DIRECTOR
2757 SLEEPY HOLLOW PL
GLENDALE CA 91206-4729

Officer/Director/Trustee Three

TAREK S HASSAN
DIRECTOR
1801 VALLEYVIEW DR
ANN ARBOR MI 48105-9564

Officer/Director/Trustee Four

JERALD A BOVINO
PRESIDENT
804 HUNTER CREEK RD
ASPEN CO 81611

Officer/Director/Trustee Five

JOHN THOMPSON
DIRECTOR
6569 N CHARLES STE 605
BALTIMORE MD 21204-6833

Organization’s website WWW.RETINAHALLOFFAME.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/9/18
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B03 - Professional Societies, Associations
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
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 ZVETAN ZAKOV
Signature Title SECRETARY-TREASURER
Signature Date 6/3/18

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