FORM 1023-EZ for JOHN T HOLZUM MEMORIAL FOUNDATION

Field Data
EIN 82-0744996
Case Number EO-2017081-000114
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name JOHN T HOLZUM MEMORIAL FOUNDATION
Organization’s Mailing Address 814 LOCUST STREET
City RED BUD
State IL
ZIP 62278
Accounting period End 12
Primary contact name CHRISTINE P MACE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOHN HOLZUM II
PRESIDENT DIRECTOR
814 LOCUST STREET
RED BUD IL 62278

Officer/Director/Trustee Two

DEBORAH YOUNG
SECRETARY DIRECTOR
3528 HIGH DRIVE
SAINT ANN MO 63074

Officer/Director/Trustee Three

JENNIFER KREITLER
VICE PRESIDENT DIRECTOR
4074 AVERY LANE
BRIDGETON MO 63044

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/31/2015
Organization Incorporation State MO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T30 - Public Foundations
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 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 Yes
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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