FORM 1023-EZ for BARTEKS HEARTS NFP

Field Data
EIN 84-2008428
Case Number EO-2019198-000192
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BARTEKS HEARTS NFP
Organization’s Mailing Address 850 S CLARK ST UNIT 613
City CHICAGO
State IL
ZIP 60605
Accounting period End 12
Primary contact name ADAM CZERNIKIEWICZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ADAM CZERNIKIEWICZ
CHAIRMAN
850 S CLARK ST UNIT 613
CHICAGO IL 60605

Officer/Director/Trustee Two

TOM PARKER
DIRECTOR
412 BRIAR PLACE
ITASCA IL 60143

Officer/Director/Trustee Three

JAREK CZERNIKIEWICZ
DIRECTOR
3 SEAWOOD COURT
SAINT LOUIS MO 63146

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/5/19
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B12 - Fund Raising and/or Fund Distribution
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 ADAM CZERNIKIEWICZ
Signature Title CHAIRMAN
Signature Date 7/15/19

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