FORM 1023-EZ for FMR FOUNDATION

Field Data
EIN 83-1506378
Case Number EO-2018222-000389
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name FMR FOUNDATION
Organization’s Mailing Address 6177 N LINCOLN AVE SUITE138
City CHICAGO
State IL
ZIP 60659
Accounting period End 12
Primary contact name SHIMON PODRIGAL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHIMON PODRIGAL
DIRECTOR
6315 N TROY APT 1
CHICAGO IL 60659

Officer/Director/Trustee Two

SARAH PODRIGAL
DIRECTOR
6315 N TROY APT 1
CHICAGO IL 60659

Officer/Director/Trustee Three

ARON PODRIGAL
DIRECTOR
6800 N CALIFORNIA AVE APT 3R
CHICAGO IL 60645

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/8/18
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code H05 - Research Institutes and/or Public Policy Analysis
Organization’s purpose Charitable: No
Religious: No
Educational: No
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 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 SHIMON PODRIGAL
Signature Title DIRECTOR
Signature Date 8/8/18

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