FORM 1023-EZ for DEWEY BURKHART MEMORIAL

Field Data
EIN 84-2739921
Case Number EO-2019242-000280
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name DEWEY BURKHART MEMORIAL
Organization’s Mailing Address 8804 JONQUIL DR
City WACO
State TX
ZIP 76708-5719
Accounting period End 12
Primary contact name AVERY ODOM
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

AVERY ODOM
CHAIRMAN OF THE BOARD
8804 JONQUIL DR
WACO TX 76708-5719

Officer/Director/Trustee Two

MICHAEL POLK
VICE CHAIRMAN
1409 HILLTOP DR
WACO TX 76710-1025

Officer/Director/Trustee Three

RONALD EWING
TREASURER
10601 RAYBURN WAY
WACO TX 76708-5731

Officer/Director/Trustee Four

GARY CARR
SECRETARY
637 BRAZOS OAKS DR
WACO TX 76705-5211

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/12/19
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G83 - Alzheimer's Disease
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 AVERY ODOM
Signature Title CHAIRMAN OF THE BOARD
Signature Date 8/28/19

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