FORM 1023-EZ for HISTORIC JOHN LANE FARM INC

Field Data
EIN 81-0970669
Case Number EO-2016305-000258
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HISTORIC JOHN LANE FARM INC
Organization’s Mailing Address 16217 S GOUGAR ROAD
City LOCKPORT
State IL
ZIP 60491
Accounting period End 12
Primary contact name SYLVIA ZIELKE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SYLVIA ZIELKE
PRESIDENT
16206 S REGENTS ROAD
HOMER GLEN IL 60491

Officer/Director/Trustee Two

ANDRIETTA BENDA
TREASURER
16221 S REGENTS ROAD
LOCKPORT IL 60491

Officer/Director/Trustee Three

CARRIE ROCK
SECRETARY
10TH STREET
LOCKPORT IL 60441

Officer/Director/Trustee Four

TOM FIJAN
DIRECTOR
16133 151ST ST
HOMER GLEN IL 60491

Officer/Director/Trustee Five

RONALD BONICK
DIRECTOR
223 E 17TH ST
LOCKPORT IL 60441

Organization’s website HISTORICJOHNLANEFARM.COM
Organization’s email HISTORIC.JOHNLANE.FARM@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/31/2015
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A80 - Historical Societies, Related Historical Activities
Organization’s purpose Charitable: No
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 Yes
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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