FORM 1023-EZ for SCOTT KLASNER ALS BENEFIT FUND

Field Data
EIN 84-3354337
Case Number EO-2019294-000267
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SCOTT KLASNER ALS BENEFIT FUND
Organization’s Mailing Address 512 WARDER AVE
City UNIVERSITY CITY
State MO
ZIP 63130
Accounting period End 12
Primary contact name STEPHEN WILLIAMS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

STEPHEN WILLIAMS
PRESIDENT & DIRECTOR
512 WARDER AVE
UNIVERSITY CITY MO 63130

Officer/Director/Trustee Two

KYLE DEUTSCH
VICE PRESIDENT & DIRECTOR
9917 VICKSBURG SIEGE CT
ST LOUIS MO 63123

Officer/Director/Trustee Three

PETE GUNTLI
SECRETARY & DIRECTOR
10104 GRANT MEADOW LANE
AFFTON MO 63123

Officer/Director/Trustee Four

GREG GUNTLI
TREASURER & DIRECTOR
15935 CYPRESS TRACE CT
CHESTERFIELD MO 63017

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/9/19
Organization Incorporation State MO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G80 - Specifically Named Diseases
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name STEPHEN WILLIAMS
Signature Title PRESIDENT & DIRECTOR
Signature Date 10/17/19

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