FORM 1023-EZ for 5-STAR EDUCATION FOUNDATION

Field Data
EIN 81-3349370
Case Number EO-2016351-000369
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name 5-STAR EDUCATION FOUNDATION
Organization’s Mailing Address 12568 KINGSTON PIKE
City KNOXVILLE
State TN
ZIP 37934
Accounting period End 12
Primary contact name EVONNE M KAUTZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

EVONNE KAUTZ
PRESIDENT
110 HILLCREST RIVER DR
KNOXVILLE TN 37774

Officer/Director/Trustee Two

JEFFREY CORNISH
VICE PRESIDENT
208 BURKHARDT ST
BENTLEYVILLE PA 15314

Officer/Director/Trustee Three

JAY POVLIN
SECRETARY
12830 STAHL DR
KNOXVILLE TN 37934

Officer/Director/Trustee Four

MICHAEL RIFFEY
TREASURER
12568 KINGSTON PIKE
KNOXVILLE TN 37934

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/14/2016
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B90 - Educational Services and Schools - Other
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 Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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