FORM 1023-EZ for THE DONALD L BLEVINS CHARITY & SCHOLARSHIP FUND CORP

Field Data
EIN 83-1386229
Case Number EO-2019035-000883
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name THE DONALD L BLEVINS CHARITY & SCHOLARSHIP FUND CORP
Organization’s Mailing Address 888 US 23 SOUTH
City PAINTSVILLE
State KY
ZIP 41240
Accounting period End 6
Primary contact name JARYD CRUM ESQ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DONALD BLEVINS
PRESIDENT
3258 S AVENUE
COLUMBUS OH 43207

Officer/Director/Trustee Two

MICKEY MCCOY
TREASURER
245 CASSADY AVE
INEZ KY 41224

Officer/Director/Trustee Three

RONALD WORKMAN
VICE PRESIDENT
211 HODE ROAD
WARFIELD KY 41267

Officer/Director/Trustee Four

KATHLEEN PRICE
SECRETARY
12 HODE ROAD
WARFIELD KY 41267

Officer/Director/Trustee Five

JOEL BLEVINS
COMMITTEE MEMBER
208 GROUNDHOG HOLLOW
WARFIELD KY 41267

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/16/18
Organization Incorporation State KY
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 DONALD BLEVINS
Signature Title PRESIDENT
Signature Date 1/14/19

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