FORM 1023-EZ for KJS MEMORIAL SCHOLARSHIP FOUNDATION

Field Data
EIN 83-1131930
Case Number EO-2018270-000348
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name KJS MEMORIAL SCHOLARSHIP FOUNDATION
Organization’s Mailing Address 48 EAST MCCULLEY COURT
City WILMINGTON
State DE
ZIP 19801
Accounting period End 12
Primary contact name ARICA SAMUELS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ARICA SAMUELS
DIRECTOR - PRESIDENT
48 EAST MCCULLEY COURT
WILMINGTON DE 19801

Officer/Director/Trustee Two

IAN PATTON
VICE-PRESIDENT
53 MCCULLEY COURT
WILMINGTON DE 19801

Officer/Director/Trustee Three

RENEE MITCHELL
SECRETARY
1203 STEVENS PLACE
WILMINGTON DE 19810

Officer/Director/Trustee Four

TAMARA BARNARD
TREASURER
450 SOUTH HYDE PLACE
BEAR DE 19701

Officer/Director/Trustee Five

KIA CAREY
BOARD MEMBER
33 BROWNING CIRCLE
MIDDLETOWN DE 19709

Organization’s website
Organization’s email KJSMEMORIALSCHOLARSHIP@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/14/18
Organization Incorporation State DE
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 Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name TAMARA BARNARD
Signature Title TREASURER
Signature Date 9/25/18

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