FORM 1023-EZ for SCREEN EDUCATION FOUNDATION

Field Data
EIN 81-3187447
Case Number EO-2017286-000227
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SCREEN EDUCATION FOUNDATION
Organization’s Mailing Address 8190-A BEECHMONT AVENUE 137
City CINCINNATI
State OH
ZIP 45255-6117
Accounting period End 12
Primary contact name MICHAEL MERCIER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MICHAEL MERCIER
PRESIDENT
8190-A BEECHMONT AVENUE 137
CINCINNATI OH 45255-6117

Officer/Director/Trustee Two

MARDELL GLINSKI SCHULTZ
DIRECTOR OF OPERATIONS
2352 RAEBURN TERRACE
CINCINNATI OH 45223-1231

Officer/Director/Trustee Three

JONATHAN CAHILL
VICE PRESIDENT
30 SAYWARD STREET
GLOUCESTER MA 01930-3133

Officer/Director/Trustee Four

DREIS VAN LANDUYT
DIRECTOR OF FUNDRAISING
1009 DELTA AVENUE
CINCINNATI OH 45208-3103

Officer/Director/Trustee Five

HEIDI MERCIER
SECRETARY/TREASURER
173 CRAGMONT DRIVE
WALNUT CREEK CA 94598-2806

Organization’s website WWW.SCREENEDUCATION.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/7/2016
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B99 - Education N.E.C.
Organization’s purpose Charitable: No
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 Yes
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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