FORM 1023-EZ for HALEY BURK MEMORIAL FOUNDATION INC

Field Data
EIN 82-5519049
Case Number EO-2018207-000241
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HALEY BURK MEMORIAL FOUNDATION INC
Organization’s Mailing Address 351 EAST CAROLINE STREET
City TRINITY
State TX
ZIP 75862
Accounting period End 12
Primary contact name SHANE PRINGLE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

HAILEY PRUITT
PRESIDENT
2830 LAKE ROAD 1206
HUNTSVILLE TX 77340

Officer/Director/Trustee Two

MITCHELL MCGHEE
VICE-PRESIDENT
120 ROY KENNEDY ROAD
TRINITY TX 75862

Officer/Director/Trustee Three

SHANE WILLIFORD
FOUNDER
351 EAST CAROLINE
TRINITY TX 75862

Officer/Director/Trustee Four

ELIZABETH SLIMP
SECRETARY
3640 FM 356
TRINITY TX 75862

Officer/Director/Trustee Five

CHERI SALBECK
TREASURER
351 EAST CAROLINE
TRINITY TX 75862

Organization’s website
Organization’s email HALEYBURKMEMORIAL@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/10/18
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S20 - Community, Neighborhood Development, Improvement (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 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 SHANE WILLIFORD
Signature Title FOUNDER
Signature Date 7/24/18

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