FORM 1023-EZ for JEFF SHIPMAN SCHOLARSHIP FOUNDATION

Field Data
EIN 47-4321248
Case Number EO-2015175-000287
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name JEFF SHIPMAN SCHOLARSHIP FOUNDATION
Organization’s Mailing Address 5290 PINE SLOPE DRIVE SW
City WYOMING
State MI
ZIP 49519-9640
Accounting period End 12
Primary contact name ROBERT C SHAVER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ANDREW SHIPMAN
DIRECTOR
5290 PINE SLOPE DRIVE SW
WYOMING MI 49519-9640

Officer/Director/Trustee Two

STEVEN SCHULTZ
DIRECTOR
7071 SUMMIT HILL COURT SE
CALEDONIA MI 49316-9070

Officer/Director/Trustee Three

ROBERT SHIPMAN
DIRECTOR
7304 BRIDGE TOWN LANE SE
CALEDONIA MI 49316-9193

Officer/Director/Trustee Four

THOMAS WILKERSON JR
DIRECTOR
7925 ALTEN OAKS LANE
ADA MI 49301-8810

Officer/Director/Trustee Five

TIMOTHY WAUBEN
DIRECTOR
1859 68TH STREET SW
BYRON CENTER MI 49315-7923

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/22/2015
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B82 - Scholarships, Student Financial Aid Services, Awards
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
Signature Title
Signature Date

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