FORM 1023-EZ for ANDY STOUT MEMORIAL SCHOLARSHIP FUND

Field Data
EIN 83-1093404
Case Number EO-2021238-000416
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ANDY STOUT MEMORIAL SCHOLARSHIP FUND
Organization’s Mailing Address 161 ROSEWOOD CT
City CHILLICOTHE
State OH
ZIP 45601
Accounting period End 12
Primary contact name ANGELA WHITE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ANGELA WHITE
PRESIDENT SECRETARY
161 ROSEWOOD CT
CHILLICOTHE OH 45601

Officer/Director/Trustee Two

JAMES WHITE
VICE PRESIDENT
161 ROSEWOOD CT
CHILLICOTHE OH 45601

Officer/Director/Trustee Three

THOMAS ALLEN
TREASURER
32 COVENTRY DR
CHILLICOTHE OH 45601

Organization’s website
Organization’s email
Organization Incorporated
Organization trust Yes
Necessary Organizing Documents Yes
Organization Incorporation Date 7/2/2018
Organization Incorporation State OH
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 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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name ANGELA WHITE
Signature Title PRESIDENT SECRETARY
Signature Date 8/25/2021

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