FORM 1023-EZ for JAMES H DAVIS SCHOLARSHIP FOUNDATION

Field Data
EIN 86-2216100
Case Number EO-2021103-000450
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name JAMES H DAVIS SCHOLARSHIP FOUNDATION
Organization’s Mailing Address 1889 THOMASSON MILL RD
City GOODVIEW
State VA
ZIP 24095
Accounting period End 12
Primary contact name NANCY AMICK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

NANCY AMICK
CHAIR
1889 THOMASSON MILL RD
GOODVIEW VA 24095

Officer/Director/Trustee Two

SUSAN TAYLOR
VICE CHAIR
5282 CHESTNUT LANE
EARLYSVILLE VA 22936

Officer/Director/Trustee Three

SANDRA BLAKE
TREASURER
6 JEFFERSON VILLAGE DR
FORREST VA 24551

Officer/Director/Trustee Four

JIM MESSIER
MEMBER
1621 KINGSTON CIRCLE
BEDFORD VA 24523

Officer/Director/Trustee Five

LEE BOYES
MEMBER
19 7TH AVE
BROOKLYN NY 11217

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/1/2021
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B80 - Student Services, Organizations of Students
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 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 NANCY AMICK
Signature Title CHAIR
Signature Date 4/7/2021

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