FORM 1023-EZ for THE ROSIE B MAYS MEMORIAL FOUNDATION

Field Data
EIN 81-5073895
Case Number EO-2017277-000121
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name THE ROSIE B MAYS MEMORIAL FOUNDATION
Organization’s Mailing Address PO BOX 774
City FLINT
State GA
ZIP 48501
Accounting period End 10
Primary contact name VERONICA SIMON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

VERONICA SIMON
PRESIDENT
PO BOX 81962
CONYERS GA 80013

Officer/Director/Trustee Two

MICHAEL EWING
VICE PRESIDENT
503 S SAGINAW ST STE 519
FLINT MI 48502

Officer/Director/Trustee Three

CARL WEATHERS
SECRETARY
3743 KENT ST
FLINT MI 48503

Officer/Director/Trustee Four

CHENITA HOLLEY
TREASURER
6101 N JENNINGS RD
MT MORRIS MI 48458

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/18/2017
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P99 - Human Services - Multipurpose and Other N.E.C.
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 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
Signature Title
Signature Date

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