FORM 1023-EZ for EXERCISE AND HEALTH FITNESS DYNAMICS SPORTS CLUB

Field Data
EIN 83-1514845
Case Number EO-2019081-000491
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name EXERCISE AND HEALTH FITNESS DYNAMICS SPORTS CLUB
Organization’s Mailing Address 16949 PARKSIDE AVE
City SOUTH HOLLAND
State IL
ZIP 60473-2945
Accounting period End 12
Primary contact name SAMPSON ILEKA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CHARLES EGBUNA
PRESIDENT
16949 PARKSIDE AVE
SOUTH HOLLAND IL 60473

Officer/Director/Trustee Two

VINCENT ONYEMA
TREASURER
35 TREE HOUSE COURT
MATTESON IL 60443

Officer/Director/Trustee Three

BEN CHARLIE
BOARD CHAIRMAN
1327 TROON STREET
FLOSSMOOR IL 60422

Officer/Director/Trustee Four

PETER OGOCHUKWU
DIRECTOR
2631 EAST MARTHA PLACE
BURNHAM IL 60633

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/11/18
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N66 - Tennis, Racquet Sports Clubs, Leagues
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 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 CHARLES EGBUNA
Signature Title PRESIDENT
Signature Date 3/20/19

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