FORM 1023-EZ for MARCIA PERNOLL FUND

Field Data
EIN 45-4458936
Case Number EO-2019060-000258
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MARCIA PERNOLL FUND
Organization’s Mailing Address 705 GREENSBURG CIRCLE
City RENO
State NV
ZIP 89509
Accounting period End 12
Primary contact name BRENDA J STOUT CPA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MARTIN PERNOLL MD
PRESIDENT
705 GREENSBURG CIRCLE
RENO NV 89509

Officer/Director/Trustee Two

MARIA STEGLICH
SECRETARY
955 EMERSON
SPARKS NV 89431

Officer/Director/Trustee Three

MARIA STEGLICH
TREASURER
955 EMERSON
SPARKS NV 89431

Officer/Director/Trustee Four

GARY YUP MD
DIRECTOR
2301 FIRESIDE CIRCLE
RENO NV 89509

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/31/12
Organization Incorporation State NV
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E99 - Health - General and Rehabilitative 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 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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name MARTIN PERNOLL MD
Signature Title PRESIDENT
Signature Date 2/26/19

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