FORM 1023-EZ for BLAKE NAWROCKI SCHOLARSHIP FOUNDATION INC

Field Data
EIN 87-2031759
Case Number EO-2021221-000306
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BLAKE NAWROCKI SCHOLARSHIP FOUNDATION INC
Organization’s Mailing Address 876 MULBERRY STREET- APT 4D
City MACON
State GA
ZIP 31201
Accounting period End 6
Primary contact name BIANCA NAWROCKI
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BIANCA NAWROCKI
INCORPORATOR AND CFO
876 MULBERRY STREET- APT 4D
MACON GA 31201

Officer/Director/Trustee Two

MARYBETH WRIGHT
CEO
1004 LEGACY WALK
WOODSTOCK GA 30189

Officer/Director/Trustee Three

CHRISTOPHER MOSES
SECRETARY
3686 KEYSTONE AVE- UNIT 6
LOS ANGELES CA 90034

Organization’s website WWW.BLAKENAWROCKISCHOLARSHIP.COM
Organization’s email BLAKENAWROCKISCHOLARSHIP@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/21/2021
Organization Incorporation State GA
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 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 Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name BIANCA NAWROCKI
Signature Title INCORPORATOR AND CFO
Signature Date 8/5/2021

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