FORM 1023-EZ for JAKOB F VON DER VELLEN MEMORIAL FOUNDATION

Field Data
EIN 46-0737997
Case Number EO-2015365-000161
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name JAKOB F VON DER VELLEN MEMORIAL FOUNDATION
Organization’s Mailing Address 965 OLD FARM TRAIL
City MEDINA
State OH
ZIP 44256
Accounting period End 12
Primary contact name KENT P VON DER VELLEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

KENT P VON DER VELLEN
PRESIDENT
965 OLD FARM TRAIL
MEDINA OH 44256

Officer/Director/Trustee Two

KIMBERLY A VON DER VELLEN
VICE PRESIDENT
965 OLD FARM TRAIL
MEDINA OH 44256

Officer/Director/Trustee Three

KIMBERLY V VON DER VELLEN
SECRETARY
965 OLD FARM TRAIL
MEDINA OH 44256

Officer/Director/Trustee Four

KENT P VON DER VELLEN
TREASURER
965 OLD FARM TRAIL
MEDINA OH 44256

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/3/2012
Organization Incorporation State OH
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 Yes
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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