FORM 1023-EZ for DARRYL USHER STUDENT ATHLETE

Field Data
EIN 83-1874212
Case Number EO-2019277-000503
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name DARRYL USHER STUDENT ATHLETE
Organization’s Mailing Address 2351 SENATOR COURT
City LOUISVILLE
State CO
ZIP 80027
Accounting period End 12
Primary contact name COREEN NICKERSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

COREEN NICKERSON
CO-FOUNDER/MANAGER
2351 SENATOR COURT
LOUISVILLE CO 80027

Officer/Director/Trustee Two

MICHAEL WILLIAMS
CO-FOUNDER/DIRECTOR
2351 SENATOR COURT
LOUISVILLE CO 80027

Officer/Director/Trustee Three

JOY STANFORD
CO-FOUNDER/DIRECTOR
4910 145TH ST NW
GIG HARBOR WA 98332

Organization’s website N/A
Organization’s email DARRYLUSHERSCHOLARSHIP@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/11/18
Organization Incorporation State WA
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: 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 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 COREEN NICKERSON
Signature Title CO-FOUNDER/MANAGER
Signature Date 9/30/19

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