FORM 1023-EZ for EVELYN HAZEL MILLER FOUNDATION

Field Data
EIN 83-1781052
Case Number EO-2020041-000475
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name EVELYN HAZEL MILLER FOUNDATION
Organization’s Mailing Address 1297 PHEASANT RUN DRIVE
City CANAL WINCHESTER
State OH
ZIP 43110
Accounting period End 12
Primary contact name PENNY MILLER - SECRETARY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MATTHEW MILLER
CEO
140 ROUNDWOOD COURT
PICKERINGTON OH 43147

Officer/Director/Trustee Two

STEVE KOLECKI
CFO
136 ROUNDWOOD COURT
PICKERINGTON OH 43147

Officer/Director/Trustee Three

KARA MILLER
CHAIRMAN
140 ROUNDWOOD COURT
PICKERINGTON OH 43147

Officer/Director/Trustee Four

PENNY MILLER
SECRETARY
1297 PHEASANT RUN DRIVE
CANAL WINCHESTER OH 43110

Officer/Director/Trustee Five

GAIL HART
TRUSTEE
120 FOX HARBOR
TROY OH 45373

Organization’s website N/A
Organization’s email EVIEBEARHUGS@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/29/2019
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T50 - Philanthropy, Charity, Voluntarism Promotion, General
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: Yes
Public Safety: No
Amateur Sports: No
Cruelty Prevention: Yes
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 PENNY MILLER
Signature Title SECRETARY
Signature Date 2/7/2020

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