FORM 1023-EZ for BREANNA NICOLE RODRIGUEZ MEMORIAL SCHOLARSHIP FOUNDATION

Field Data
EIN 81-3668987
Case Number EO-2017075-000426
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BREANNA NICOLE RODRIGUEZ MEMORIAL SCHOLARSHIP FOUNDATION
Organization’s Mailing Address 1975 S BROADWAY SUITE K1014
City SANTA MARIA
State CA
ZIP 93454
Accounting period End 12
Primary contact name ISABEL GERARDO RODRIGUEZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ISABEL GERARDO RODRIGUEZ
DIRECTOR
1942 VIA ESTABLO
SANTA MARIA CA 93458

Officer/Director/Trustee Two

RENE RODRIGUEZ SR
PRESIDENT
1461 W WYNNDEL WAY
SANTA MARIA CA 93458

Officer/Director/Trustee Three

SAM MORENO
VICE PRESIDENT
731 CORDIAL COURT
SANTA MARIA CA 93458

Officer/Director/Trustee Four

NORMA MORENO
TREASURER
731 CORDIAL COURT
SANTA MARIA CA 93458

Officer/Director/Trustee Five

JOANNE ZAZUETA
SECRETARY
1666 OLIVE STREET
BAKERSFIELD CA 93301

Organization’s website WWW.FACEBOOK.COM/PG/FORBREE/
Organization’s email FORBREE@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/27/2016
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T31 - Community Foundations
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 Yes
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
Signature Title
Signature Date

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