FORM 1023-EZ for DON ROSE SR SCHOLARSHIP FUND INC

Field Data
EIN 46-4996626
Case Number EO-2015177-000314
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name DON ROSE SR SCHOLARSHIP FUND INC
Organization’s Mailing Address PO BOX 1879
City LEESBURG
State VA
ZIP 20177
Accounting period End 12
Primary contact name ERIC V ZIMMERMAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DONALD ROSE JR
DIRECTOR
335 NANSEMOND STREET SE
LEESBURG VA 20175

Officer/Director/Trustee Two

LYNNA ROSE
SECRETARY/DIRECTOR
335 NANSEMOND STREET SE
LEESBURG VA 20175

Officer/Director/Trustee Three

PENROD ROSE
TREASURER/DIRECTOR
603 KINVARRA ROAD
PURCELLVILLE VA 20132

Officer/Director/Trustee Four

J MICHAEL ROSE
DIRECTOR
841 OLD CHARLES TOWN ROAD
STEPHENSON VA 22656

Officer/Director/Trustee Five

SHARRY GARRISON
DIRECTOR
57 HONEYSUCKLE LANE
BLUEMONT VA 20135

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/12/2013
Organization Incorporation State VA
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
Signature Title
Signature Date

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