FORM 1023-EZ for SCHOLARSHIP FOUNDATION FOR HIDE-A-WAY LAKE STUDENTS

Field Data
EIN 83-4430068
Case Number EO-2019126-000659
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SCHOLARSHIP FOUNDATION FOR HIDE-A-WAY LAKE STUDENTS
Organization’s Mailing Address PO BOX 53
City CARRIERE
State MS
ZIP 39426
Accounting period End 12
Primary contact name THOMAS GIBILTERRA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KATHLEEN H BUSCO
PRESIDENT
304 EAST LAKESHORE DR
CARRIERE MS 39426

Officer/Director/Trustee Two

DONNA DEEN RUSHTON
VICE PRESIDENT
1706 EAST LAKESHORE DR
CARRIERE MS 39426

Officer/Director/Trustee Three

SUSAN J GIBILTERRA
TREASURER
1406 EAST LAKSHORE DR
CARRIERE MS 39426

Officer/Director/Trustee Four

TERRI ANNE TOMLIN
SECRETARY
101 WESTSIDE CIRCLE
CARRIERE MS 39426

Officer/Director/Trustee Five

ELIZABETH G ENNIS
DIRECTOR
12 GLENBROOK CT
CARRIERE MS 39426

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/1/19
Organization Incorporation State MS
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: No
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 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 SUSAN J GIBILTERRA
Signature Title TREASURER
Signature Date 5/4/19

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