FORM 1023-EZ for COMMUNITY BLOCK CLUB OF UP

Field Data
EIN 36-4863667
Case Number EO-2019119-000198
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name COMMUNITY BLOCK CLUB OF UP
Organization’s Mailing Address 622 OLD FORGE LN
City UNIVERSITY PARK
State IL
ZIP 60484
Accounting period End 12
Primary contact name SHEILA PETTER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MARY TRUSS
PRESIDENT
622 OLD FORGE LN
UNIVERSITY PARK IL 60848

Officer/Director/Trustee Two

SHEILA PETTER
TREASURER
1059 AMHERST LN
UNIVERSITY IL 60484

Officer/Director/Trustee Three

PHYLLIS SAUNDERS
SECRETARY
821 UNION DR
UNIVERSITY PARK IL 60484

Officer/Director/Trustee Four

SONIA BELL
DIRECTOR
1024 MONTERY CT
UNIVERSITY PARK IL 60484

Officer/Director/Trustee Five

HARVEY DODD
DIRECTOR
615 OLD FORGE LN
UNIVERSITY PARK IL 60484

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/27/17
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N50 - Recreational, Pleasure, or Social Club
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 Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name MARY TRUSS
Signature Title PRESIDENT
Signature Date 4/25/19

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