FORM 1023-EZ for THE DANNY JO SIMS CANCER FOUNDATION

Field Data
EIN 47-5276625
Case Number EO-2016071-000056
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name THE DANNY JO SIMS CANCER FOUNDATION
Organization’s Mailing Address 75 ODYSSEY DR
City TINLEY PARK
State IL
ZIP 60477
Accounting period End 12
Primary contact name DONNA SIMS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DONNA SIMS
CHIEF EXECUTIVE OFFICER
75 ODYSSEY DRIVE
TINLEY PARK IL 60477

Officer/Director/Trustee Two

ELLSWORTH GRANT
CHIEF OPERATING OFFICER
1000 E OCEAN BLVD UNIT 201
LONG BEACH IL 90802

Officer/Director/Trustee Three

WANDA HIGGENBOTHAM
DIRECTOR OF NURSING
2712 CHAYES PARK DRIVE
FLOSSMOOR IL 60422

Officer/Director/Trustee Four

DAWN ADAMS
CHIEF FINANCIAL OFFICER
931 ARQUILLA DRIVE UNIT 234
GLENWOOD IL 60425

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/24/2015
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G30 - Cancer
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: Yes
Public Safety: No
Amateur Sports: No
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee Yes
Donation of funds Yes
Conducting Activities Outside of United States Yes
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
Signature Title
Signature Date

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