FORM 1023-EZ for THE TOM HENSON MEMORIAL FIREFIGHTERSCHOLARSHIP FUND

Field Data
EIN 83-1554976
Case Number EO-2018269-000273
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name THE TOM HENSON MEMORIAL FIREFIGHTERSCHOLARSHIP FUND
Organization’s Mailing Address 848 TALL TIMBER LANE
City SULLIVAN
State MO
ZIP 63080
Accounting period End 12
Primary contact name JASON M HOEVELMANN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JASON HOEVELMANN
OFFICER
848 TALL TIMBER LANE
SULLIVAN MO 63080

Officer/Director/Trustee Two

KAREN DERRINGTON
OFFICER
1028 PEARVIEW DR
ST. PETERS MO 63376

Officer/Director/Trustee Three

TRICIA BLANKENSHIP
OFFICER
2249 NOWACK RD
ROSEBUD MO 63091

Officer/Director/Trustee Four

KELLY HENSON
OFFICER
7736 MEADOW VIEW CIRCLE
UNION MO 63084

Officer/Director/Trustee Five

BRADLEY HENSON
OFFICER
4220 ROCK ROAD
BOURBON MO 65441

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/6/18
Organization Incorporation State MO
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: No
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name JASON HOEVELMANN
Signature Title OFFICER
Signature Date 9/24/18

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