FORM 1023-EZ for ANDREW CLAYTON FOUNDATION
| Field | Data |
|---|---|
| EIN | 82-4996489 |
| Case Number | EO-2018136-000441 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | ANDREW CLAYTON FOUNDATION |
| Organization’s Mailing Address | 444 W FULLERTON PARKWAY ROOM 1804 |
| City | CHICAGO |
| State | IL |
| ZIP | 60614 |
| Accounting period End | 12 |
| Primary contact name | NICK BERG |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
NICK BERG
PRESIDENT
444 W FULLERTON PARKWAY APT 1804
CHICAGO IL 60614
Officer/Director/Trustee Two
BROOKSANN HARSHAW
DIRECTOR
9345 S STATE ROAD
GOODRICH MI 48438
Officer/Director/Trustee Three
COLLEEN BERG
DIRECTOR
816 SUMNER DRIVE APT 30
FAYETTEVILLE NC 28303
Officer/Director/Trustee Four
CANDACE MITCHELL
DIRECTOR
9715 MATZON DRIVE
MIDDLE RIVER MD 21220
| Organization’s website | WWW.ANDREWCLAYTONFOUNDATION.ORG |
|---|---|
| Organization’s email | ANDREWCLAYTONFOUNDATION@GMAIL.COM |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 3/23/18 |
| Organization Incorporation State | IL |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | P60 - Emergency Assistance (Food, Clothing, Cash) |
| 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 | 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 | NICK BERG |
| Signature Title | PRESIDENT |
| Signature Date | 5/14/18 |
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