FORM 1023-EZ for MADISON STERN MEMORIAL SCHOLARSHIP

Field Data
EIN 84-5132349
Case Number EO-2020098-000068
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MADISON STERN MEMORIAL SCHOLARSHIP
Organization’s Mailing Address 3103 NY 43
City AVERILL PARK
State NY
ZIP 12018
Accounting period End 12
Primary contact name MICHAEL OUIMET
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KERI STERN
PRESIDENT
3103 NY 42
AVERILL PARK NY 12018

Officer/Director/Trustee Two

PATRICIA DAVIERO
VICE PRESIDENT
1301 NORTH MANSION RD
DUANESBURG NY 12056

Officer/Director/Trustee Three

LORI FLINT
TREASURER
63 COLUMBIA HILL RD
AVERILL PARK NY 12018

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/1/2019
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B11 - Single Organization Support
Organization’s purpose Charitable: No
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 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 KERI STERN
Signature Title PRESIDENT
Signature Date 4/1/2020

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