FORM 1023-EZ for THOM STOREY SCHOLARSHIP FUND

Field Data
EIN 84-2180691
Case Number EO-2019178-000118
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name THOM STOREY SCHOLARSHIP FUND
Organization’s Mailing Address 1430 BRIGHTON CIRCLE
City OLD HICKORY
State TN
ZIP 37138-1681
Accounting period End 12
Primary contact name PETER STOREY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CAROLINE STOREY
PRESIDENT
1430 BRIGHTON CIRCLE
OLD HICKORY TN 37138-1681

Officer/Director/Trustee Two

PETER STOREY
TREASURER
6934 LOCKWOOD LANE
LOCKPORT NY 14094-7918

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/10/19
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B12 - Fund Raising and/or Fund Distribution
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 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 PETER STOREY
Signature Title TREASURER
Signature Date 6/25/19

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