FORM 1023-EZ for DERRICK G SIMS SCHOLARSHIP FOUNDATION

Field Data
EIN 83-1627552
Case Number EO-2018256-000326
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name DERRICK G SIMS SCHOLARSHIP FOUNDATION
Organization’s Mailing Address P O BOX 380012
City KANSAS CITY
State MO
ZIP 64134
Accounting period End 12
Primary contact name CARLA R MANN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CARLA MANN
CHAIRPERSON
111 W 99TH TERR APT 209
KANSAS CITY MO 64114

Officer/Director/Trustee Two

D ANGELA JOHNSON
CO-CHAIRPERSON
5429 INDIANA
KANSAS CITY MO 64130

Officer/Director/Trustee Three

ASTRID WHITE
TREASURER
11824 EAST 56TH STREE
KANSAS CITY MO 64133

Officer/Director/Trustee Four

PHYLISHIA JACKSON
SECRETARY
4426 BENTON BLVD
KANSAS CITY MO 64130

Officer/Director/Trustee Five

MAURICE GAY
TRUSTEE
6024 EAST 129TH STREET
GRANDVIEW MO 64030

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/11/18
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: Yes
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 Yes
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name CARLA MANN
Signature Title CHAIRPERSON
Signature Date 9/11/18

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