FORM 1023-EZ for ROGER JACOB PALACIOS MEMORIAL SCHOLARSHIP PLAY WITH PASSION12 INC

Field Data
EIN 27-3126639
Case Number EO-2015026-000068
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ROGER JACOB PALACIOS MEMORIAL SCHOLARSHIP PLAY WITH PASSION12 INC
Organization’s Mailing Address 332 CHOCTAW PLACE
City YUKON
State OK
ZIP 73099
Accounting period End 12
Primary contact name RITO PALACIOS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

RITO PALACIOS
BOARD MEMBER
332 CHOCTAW PLACE
YUKON OK 73099

Officer/Director/Trustee Two

GLORIA PALACIOS
BOARD MEMBER
332 CHOCTAW PLACE
YUKON OK 73099

Officer/Director/Trustee Three

BEN BRAUDERICK
BOARD MEMBER
332 CHOCTAW PLACE
YUKON OK 73099

Officer/Director/Trustee Four

MARIA ALVAREZ
BOARD MEMBER
332 CHOCTAW PLACE
YUKON OK 73099

Officer/Director/Trustee Five

SAMANTHA HERNANDEZ
BOARD MEMBER
332 CHOCTAW PLACE
YUKON OK 73099

Organization’s website PLAYWITHPASSION12.COM
Organization’s email GPALACIOS1212@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/1/2001
Organization Incorporation State OK
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O12 - Fund Raising and/or Fund Distribution
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 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 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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