FORM 1023-EZ for COLUMBIA LODGE 25 AF AM SCHOLARSHIP FUND INC

Field Data
EIN 47-4926149
Case Number EO-2015071-000959
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name COLUMBIA LODGE 25 AF AM SCHOLARSHIP FUND INC
Organization’s Mailing Address 895 MAIN STREET
City GLASTONBURY
State CT
ZIP 06033
Accounting period End 12
Primary contact name KRISTI GARDNER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MICHAEL HUDSON
PRESIDENT
41 WESTVIEW DRIVE
EAST HARTFORD CT 06118

Officer/Director/Trustee Two

WALTER GRUBE
SECRETARY
149 OVERLOOK ROAD
GLASTONBURY CT 06033

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/17/2012
Organization Incorporation State CT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B12 - 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 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
Signature Title
Signature Date

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