FORM 1023-EZ for CHICAGO BLUES REVIVAL

Field Data
EIN 83-2640134
Case Number EO-2019029-001005
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CHICAGO BLUES REVIVAL
Organization’s Mailing Address 10557 S OAKLEY AVE
City CHICAGO
State IL
ZIP 60643-2525
Accounting period End 12
Primary contact name JEFFREY PINZINO
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JEFFREY PINZINO
PRESIDENT
10557 S OAKLEY AVE
CHICAGO IL 60643-2525

Officer/Director/Trustee Two

MARK CARLSON
VICE-PRESIDENT
10046 S HOMAN
EVERGREEN PARK IL 60805-3409

Officer/Director/Trustee Three

AARON GROFF
TREASURER
9641 S OAKLEY AVE
CHICAGO IL 60643-1718

Officer/Director/Trustee Four

JOEL BARR
SECRETARY
9709 S PROSPECT AVE
CHICAGO IL 60643-1223

Organization’s website
Organization’s email JEFFPINZINO@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/27/18
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A68 - Music
Organization’s purpose Charitable: Yes
Religious: No
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 JEFFREY PINZINO
Signature Title PRESIDENT
Signature Date 12/20/18

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