FORM 1023-EZ for ANGEL ON THIRD BLAKE PAMLER SCHOLARSHIP FOUNDATION

Field Data
EIN 83-3847417
Case Number EO-2019093-000148
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ANGEL ON THIRD BLAKE PAMLER SCHOLARSHIP FOUNDATION
Organization’s Mailing Address PO BOX 1558
City SHELBYVILLE
State KY
ZIP 40066
Accounting period End 2
Primary contact name MATTHEW BIDWELL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MATTHEW BIDWELL
OFFICER
368 WOODLAWN RD
SHELBYVILE KY 40065

Officer/Director/Trustee Two

CASANDRA BIDWELL
OFFICER
368 WOODLAWN RD
SHELBYVILLE KY 40065

Officer/Director/Trustee Three

MICHAEL DUGLE
TREASURER
9065 CHARLESTON WAY
SHELBYVILLE KY 40065

Officer/Director/Trustee Four

SUSAN DUGLE
ADVISOR
9065 CHARLESTON WAY
SHELBYVILLE KY 40065

Officer/Director/Trustee Five

DANIEL BENTLEY
ADVISOR
8891 FRANKFORT RD
WADDY KY 40076

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/8/19
Organization Incorporation State KY
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: 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 Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name MATTHEW BIDWELL
Signature Title OFFICER
Signature Date 3/31/19

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