FORM 1023-EZ for THE CONCRETE COMMUNITY SCHOLARSHIPFUND

Field Data
EIN 81-3270285
Case Number EO-2016202-000425
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name THE CONCRETE COMMUNITY SCHOLARSHIPFUND
Organization’s Mailing Address 3315 169TH AVE CT E
City LAKE TAPPS
State WA
ZIP 98391-5558
Accounting period End 12
Primary contact name KRISTINE DUNCAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KRISTINE DUNCAN
EXECUTIVE DIRECTOR
3315 169TH AVE CT E
LAKE TAPPS WA 98391-5558

Officer/Director/Trustee Two

LORRAINE SIMPSON
DIRECTOR
3314 169TH AVE CT E
LAKE TAPPS WA 98391-5558

Officer/Director/Trustee Three

MICHAEL DUNCAN
OFFICER TREASURER
3315 169TH AVE CT E
LAKE TAPPS WA 98391-5558

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/14/2016
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W12 - Fund Raising and/or Fund Distribution
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
Signature Title
Signature Date

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