FORM 1023-EZ for VITARBR

Field Data
EIN 81-1535856
Case Number EO-2016347-000306
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name VITARBR
Organization’s Mailing Address 123 BROOK HILL LANE
City VERNON HILLS
State IL
ZIP 60061-3141
Accounting period End 12
Primary contact name PAUL WINTERS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MONAL B SHAH
PRESIDENT / DIRECTOR
123 BROOK HILL LANE
VERNON HILLS IL 60061-3141

Officer/Director/Trustee Two

VINOD KOOSAM
TREASURER / DIRECTOR
255 SOMERSET CT
ATLANTA GA 30350-3433

Officer/Director/Trustee Three

HARISH KOLASANI
SECRETARY / DIRECTOR
29 NICOLETTE AVE
SCHAUMBURG IL 60173-6181

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/18/2016
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F99 - Mental Health, Crisis Intervention N.E.C.
Organization’s purpose Charitable: Yes
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 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
Signature Title
Signature Date

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