FORM 1023-EZ for AMERICAN INTEGRITY CHRISTIAN CHAPLAIN AUTHORITY INC

Field Data
EIN 47-3545808
Case Number EO-2017006-000116
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name AMERICAN INTEGRITY CHRISTIAN CHAPLAIN AUTHORITY INC
Organization’s Mailing Address 4963 FAIROAKS DR
City COUNTRY CLUB HILLS
State IL
ZIP 60478-2924
Accounting period End 12
Primary contact name ANTHONY TILLER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ANTHONY TILLER
EXECUTIVE DIRECTOR
4963 FAIROAKS DR
COUNTRY CLUB HILLS IL 60478-2924

Officer/Director/Trustee Two

DORIS WILLIAMS
SECRETARY
1513 LOWE
CHICAGO HEIGHTS IL 60411-3536

Officer/Director/Trustee Three

DENISE LONDON
TREASUER
1355 BURNHAM AVE
CALUMET CITY IL 60409-5938

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/23/2015
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X20 - Christian
Organization’s purpose Charitable: Yes
Religious: Yes
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 Yes
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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