FORM 1023-EZ for THE SAMUEL QUINN FOUNDATION INC

Field Data
EIN 85-2634382
Case Number EO-2020237-000665
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name THE SAMUEL QUINN FOUNDATION INC
Organization’s Mailing Address 2024 S WABASH AVE APT 301
City CHICAGO
State IL
ZIP 60616
Accounting period End 12
Primary contact name STEPHANIE JERNAGIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

STEPHANIE JERNAGIN
FOUNDER AND PRESIDENT
2024 S WABASH AVE APT 301
CHICAGO IL 60616

Officer/Director/Trustee Two

AZALEA HUTCHINS
DIRECTOR
630 PACES PKWY APT 302
WOODSTOCK GA 30189

Officer/Director/Trustee Three

AUDRIE HUTCHINS
DIRECTOR
600 PACES PKWY APT 206
WOODSTOCK GA 30189

Officer/Director/Trustee Four

QUINN THOMPSON
DIRECTOR
250 KAWAIHAE ST UNIT 11D
HONOLULU HI 96825

Organization’s website
Organization’s email THESAMUELQUINNFOUNDATION@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/17/2020
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F60 - Counseling, Support Groups
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 STEPHANIE JERNAGIN
Signature Title FOUNDER AND PRESIDENT
Signature Date 8/21/2020

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