FORM 1023-EZ for PEORIA AREA PROSTATE AWARENESS SOCIETY II NFP

Field Data
EIN 83-1784518
Case Number EO-2018249-000204
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PEORIA AREA PROSTATE AWARENESS SOCIETY II NFP
Organization’s Mailing Address 1515 KNOX RD 1550 N
City DAHINDA
State IL
ZIP 61428
Accounting period End 12
Primary contact name GREGORY H WAHL DDS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

GREGORY H WAHL
PRESIDENT
1515 KNOX RD 1550 N
DAHINDA IL 61428

Officer/Director/Trustee Two

JOHN SPEARS
TREASURER
2801 W FARMINGTON ROAD
PEORIA IL 61604

Officer/Director/Trustee Three

JAMES W SPEARS
VICE PRESIDENT
2801 W FARMINGTON ROAD
PEORIA IL 61604

Officer/Director/Trustee Four

TARA SUZUKI-NGUYEN
SECRETARY
1723 W BEL AIRE
PEORIA IL 61614

Officer/Director/Trustee Five

JAMIE H CERCONE
DIRECTOR (1 OF 5)
501 W MILTON AVENUE
LEWISTOWN IL 61542

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/20/18
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code H12 - 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 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 GREGORY H WAHL
Signature Title PRESIDENT
Signature Date 9/4/18

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