| Field | Data |
|---|---|
| EIN | 54-1920205 |
| Case Number | EO-2016225-000093 |
| Form 1023-EZ version | 62014 |
| Eligibility Worksheet | 1 |
| Organization Name | CHUCK PETERSEN MEMORIAL SCHOLARSHIP |
| Organization’s Mailing Address | 366 CARRERA DRIVE |
| City | MILL VALLEY |
| State | CA |
| ZIP | 94941-5404 |
| Accounting period End | 12 |
| Primary contact name | JAN MCDOUGAL |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
JAN MCDOUGAL
DIRECTOR
366 CARRERA DRIVE
MILL VALLEY CA 94941-5404
BARBARA PETERSEN
DIRECTOR
1199 PACIFIC HIGHWAY APT 1705
SAN DIEGO CA 92101-3325
ALYSSA BRUST
DIRECTOR
1082 DODGE HILL RD
HENNIKER NH 03242-4101
RON PETERSEN
DIRECTOR
S78 W20055 BURNING WOOD CT
MUSKEGO WI 53150-8124
| Organization’s website | WWW.CHUCKPETERSEN.COM |
|---|---|
| Organization’s email | CHUCK_PETERSEN@YAHOO.COM |
| Organization Incorporated | No |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 8/9/2016 |
| Organization Incorporation State | CA |
| 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: Yes 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 | No |
| Seeking Section 7 Reinstatement | No |
| Correctness Declaration | Yes |
| Signature Name | |
| Signature Title | |
| Signature Date |
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