FORM 1023-EZ for ETHAN BUSBY MEMORIAL INC

Field Data
EIN 84-2148708
Case Number EO-2020303-000050
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ETHAN BUSBY MEMORIAL INC
Organization’s Mailing Address 491 CR 4200
City WINNSBORO
State TX
ZIP 75494
Accounting period End 12
Primary contact name KAITIE BASS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KAITIE BASS
SECRETARY
491 CR 4200
WINNSBORO TX 75494

Officer/Director/Trustee Two

JIMMY BUSBY
PRESIDENT
491 CR 4200
WINNSBORO TX 75494

Officer/Director/Trustee Three

DENISE WILLIAMS
DIRECTOR
491 CR 4200
WINNSBORO TX 75494

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/16/2019
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B82 - Scholarships, Student Financial Aid Services, Awards
Organization’s purpose Charitable: No
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 Yes
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 KAITIE BASS
Signature Title SECRETARY
Signature Date 10/27/2020

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