FORM 1023-EZ for THE BERTHA BARAJAS SCHOLARSHIP

Field Data
EIN 47-3054162
Case Number EO-2016301-000255
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name THE BERTHA BARAJAS SCHOLARSHIP
Organization’s Mailing Address 2615 ORCHARD CREST LN
City CORONA
State CA
ZIP 92881-3553
Accounting period End 12
Primary contact name THOMAS BROERSMA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

THOMAS BROERSMA
CEO
2615 ORCHARD CREST
CORONA CA 92881-3553

Officer/Director/Trustee Two

JENNIFER RODELA
SECRETARY
2615 ORCHARD CREST LN
CORONA CA 92881-3553

Officer/Director/Trustee Three

ERIKA BARAJAS
CFO
2615 ORCHARD CREST LN
CORONA CA 92881-3553

Organization’s website
Organization’s email THEBERTHABARAJASSCHOLARSHIP@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/15/2016
Organization Incorporation State CA
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
Signature Title
Signature Date

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