FORM 1023-EZ for TAD SIMMONS MEMORIAL FOUNDATIN NFP

Field Data
EIN 47-1109257
Case Number EO-2016169-000117
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name TAD SIMMONS MEMORIAL FOUNDATIN NFP
Organization’s Mailing Address 815 W DIVISION
City MARINE
State IL
ZIP 62061
Accounting period End 5
Primary contact name MATTHEW OPEL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MATTHEW OPEL
PRESIDENT
524 N VERSON
MARINE IL 62061

Officer/Director/Trustee Two

ETHAN FIELD
SECRETARY
815 W DIVISION
MARINE IL 62061

Officer/Director/Trustee Three

JASON HILL
MEMBER OF THE BOARD
524 N VERSON
MARINE IL 62061

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/30/2014
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T22 - Private Independent Foundations
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 Yes
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity Yes
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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