FORM 1023-EZ for PAVE IT FORWARD

Field Data
EIN 84-2181557
Case Number EO-2019182-000370
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PAVE IT FORWARD
Organization’s Mailing Address 251 N GARDEN AVE
City ROSELLE
State IL
ZIP 60172
Accounting period End 12
Primary contact name TODD EICHHOLZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TODD EICHHOLZ
DIRECTOR
208 TOWN ACRES LANE
ROSELLE IL 60172

Officer/Director/Trustee Two

JAIME EICHHOLZ
OFFICER
208 TOWN ACRES LANE
ROSELLE IL 60172

Officer/Director/Trustee Three

DAVE PAWELEK
OFFICER
337 WHITEHALL TERRACE
BLOOMINGDALE IL 60108

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/21/19
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S20 - Community, Neighborhood Development, Improvement (General)
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 TODD EICHHOLZ
Signature Title DIRECTOR
Signature Date 6/26/19

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