FORM 1023-EZ for CHARLES R SANDRA G HENRY FOUNDATION INC

Field Data
EIN 82-5093020
Case Number EO-2018106-001093
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CHARLES R SANDRA G HENRY FOUNDATION INC
Organization’s Mailing Address 5311 BAYVIEW DRIVE
City FORT LAUDERDALE
State FL
ZIP 33308
Accounting period End 12
Primary contact name MICHAEL J KIERZYNSKI
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CHARLES HENRY
DIRECTOR/PRESIDENT
5311 BAYVIEW DRIVE
FORT LAUDERDALE FL 33308

Officer/Director/Trustee Two

SANDRA HENRY
DIRECTOR/VICE PRES
5311 BAYVIEW DRIVE
FORT LAUDERDALE FL 33308

Officer/Director/Trustee Three

KATHRYN HENRY
DIRECTOR/SECRETARY
7116 BEDSTRAW DRIVE
SPRINGFIELD VA 22152

Officer/Director/Trustee Four

MARK HENRY
DIRECTOR/TREASURER
1090 HAMPTON PLACE
BIRMINGHAM AL 35242

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/29/18
Organization Incorporation State FL
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 No
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name CHARLES HENRY
Signature Title DIRECTOR/PRESIDENT
Signature Date 4/12/18

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