FORM 1023-EZ for ZEBULON HEALTH SOLUTIONS

Field Data
EIN 85-0821726
Case Number EO-2020122-000317
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ZEBULON HEALTH SOLUTIONS
Organization’s Mailing Address 1900 E GOLF RD STE 950A
City SCHAMBURG
State IL
ZIP 60173
Accounting period End 12
Primary contact name LA SHAWN WALLACE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LA SHAWN WALLACE
BOARD CHAIR, CEO, ED
740 E 104TH STREET
CHICAGO IL 60628

Officer/Director/Trustee Two

KENNETH TAYLOR
VICE CHAIR
8546 S CHAPPEL
CHICAGO IL 60617

Officer/Director/Trustee Three

RAGNAR WALLACE
TREASURE
740 E 104TH STREET
CHICAGO IL 60628

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/20/2020
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X99 - Religion Related, Spiritual Development N.E.C.
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
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 LA SHAWN WALLACE
Signature Title BOARD CHAIR, CEO, ED
Signature Date 4/29/2020

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