FORM 1023-EZ for SHARI LYNN CRUSSE FOUNDATION

Field Data
EIN 82-1854578
Case Number EO-2019036-001140
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SHARI LYNN CRUSSE FOUNDATION
Organization’s Mailing Address 21230 RIO ORO DRIVE
City CORNELIUS
State NC
ZIP 28031
Accounting period End 12
Primary contact name MATTHEW CRUSSE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PATRICK M CRUSSE
PRESIDENT
21230 RIO ORO DRIVE
CORNELIUS NC 28031

Officer/Director/Trustee Two

MATTHEW CRUSSE
VICE PRESIDENT
21230 RIO ORO DRIVE
CORNELIUS NC 28031

Officer/Director/Trustee Three

GEORGE ROBERT CRUSSE
SECRETARY/TREASURER
21230 RIO ORO DRIVE
CORNELIUS NC 28031

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/28/17
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E80 - Health, General and Financing
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 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 MATTHEW CRUSSE
Signature Title VICE PRESIDENT
Signature Date 1/23/19

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