FORM 1023-EZ for TRANSFORM AMERICA NFP

Field Data
EIN 37-1911154
Case Number EO-2018324-000099
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name TRANSFORM AMERICA NFP
Organization’s Mailing Address 19820 WOLF ROAD UNIT C
City MOKENA
State IL
ZIP 60448
Accounting period End 12
Primary contact name DARIN STEEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DARIN STEEN
PRESIDENT
19820 WOLF ROAD UNIT C
MOKENA IL 60448

Officer/Director/Trustee Two

DEBBIE JACKSON
TREASURER
130 DARTMOUTH DR
BOURBONNAIS IL 60914

Officer/Director/Trustee Three

KIANA STEEN
SECRETARY
11629 SEMINOLE CT APT 8
MOKENA IL 60448

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/26/18
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P40 - Family Services
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 DARIN STEEN
Signature Title PRESIDENT
Signature Date 11/18/18

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