FORM 1023-EZ for KELLY S BALSER SCHOLARSHIP FOUNDATION

Field Data
EIN 87-2275238
Case Number EO-2021235-000675
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name KELLY S BALSER SCHOLARSHIP FOUNDATION
Organization’s Mailing Address 2015 SHADOW PARK DRIVE
City KATY
State TX
ZIP 77494
Accounting period End 12
Primary contact name MARK BALSER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MARK BALSER
PRESIDENT
2015 SHADOW PARK DRIVE
KATY TX 77494

Officer/Director/Trustee Two

MARCI COCHRAN
VICE PRESIDENT
1102 WILSON BOULEVARD
ANDERSON IN 46012

Officer/Director/Trustee Three

HALEE SPITZENBERGER
TREASURER
27410 STARLIT LANE DRIVE
KATY TX 77494

Officer/Director/Trustee Four

LANCE BALSER
SECRETARY
2015 SHADOW PARK DRIVE
KATY TX 77494

Officer/Director/Trustee Five

BECKY HICKMAN
DIRECTOR
22627 CAPITOL LANDING
KATY TX 77449

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/17/2021
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N12 - Fund Raising and/or Fund Distribution
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 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 MARK BALSER
Signature Title PRESIDENT
Signature Date 8/20/2021

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