FORM 1023-EZ for CAPITIS MEDIA FOUNDATION

Field Data
EIN 47-2218259
Case Number EO-2016273-000397
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CAPITIS MEDIA FOUNDATION
Organization’s Mailing Address 324 W BURLINGTON AVE
City LA GRANGE
State IL
ZIP 60525
Accounting period End 12
Primary contact name ANTHONY FRENCH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ANTHONY FRENCH
REGISTERED AGENT, DIRECTOR
961 RIDGEWOOD DRIVE
HIGHLAND PARK IL 60035

Officer/Director/Trustee Two

MICHAEL MCDONNELL
DIRECTOR
8051 W 131ST STREET
PALOS PARK IL 60464

Officer/Director/Trustee Three

DAVID MCGARRY
DIRECTOR
2803 CORDGRASS ROAD
NAPERVILLE IL 60564

Organization’s website WWW.CAPITISMEDIAFOUNDATION.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/27/2016
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T50 - Philanthropy, Charity, Voluntarism Promotion, General
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
Signature Title
Signature Date

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