FORM 1023-EZ for JEFF ELLISON MEMORIAL SCHOLARSHIP FUND

Field Data
EIN 82-4153094
Case Number EO-2018033-000322
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name JEFF ELLISON MEMORIAL SCHOLARSHIP FUND
Organization’s Mailing Address PO BOX 215
City SHIRLEY
State IN
ZIP 47384-215
Accounting period End 11
Primary contact name BRIAN FROMAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PAUL ADKINS
CHAIRMAN
5195S 625W
KNIGHTSTOWN IN 46148-9242

Officer/Director/Trustee Two

TRACY BADGLEY
VICE-CHAIRMAN
5195S 625W
KNIGHTSTOWN IN 46148-9242

Officer/Director/Trustee Three

RUSTY PARKE
TRUSTEE
10853E 700N
WILKINSON IN 46186-9792

Officer/Director/Trustee Four

BRIAN FROMAN
SECRETARY
8868E SR234
WILKINSON IN 46186-9621

Officer/Director/Trustee Five

RONALD WILLIS
TREASURER
220 MERIDIAN ST PO BOX 27
SHIRLEY IN 47384-27

Organization’s website
Organization’s email SHIRLEYLODGE531@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/2/72
Organization Incorporation State IN
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 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 BRIAN FROMAN
Signature Title SECRETARY
Signature Date 1/31/18

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