FORM 1023-EZ for PBLA CHARITABLE FOUNDATION

Field Data
EIN 45-3341924
Case Number EO-2018051-000260
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PBLA CHARITABLE FOUNDATION
Organization’s Mailing Address PO BOX 2292
City MIDLAND
State TX
ZIP 79702-2292
Accounting period End 12
Primary contact name MOLLIE MCAULIFFE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JASON SOUTH
PRESIDENT, DIRECTOR
PO BOX 2292
MIDLAND TX 79702-2292

Officer/Director/Trustee Two

CARSON BUCKLES
FIRST VICE PRESIDENT, DIRECTOR
PO BOX 2292
MIDLAND TX 79702-2292

Officer/Director/Trustee Three

WENDY DALTON
SECOND VICE PRESIDENT, DIRECTOR
PO BOX 2292
MIDLAND TX 79702-2292

Officer/Director/Trustee Four

AMANDA LABRIE
, DIRECTOR
PO BOX 2292
MIDLAND TX 79702-2292

Officer/Director/Trustee Five

TIP KIRWAN
SECRETARY, DIRECTOR
PO BOX 2292
MIDLAND TX 79702-2292

Organization’s website NA
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/24/11
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T03 - Professional Societies, Associations
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 JASON SOUTH
Signature Title PRESIDENT, DIRECTOR
Signature Date 2/16/18

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