FORM 1023-EZ for PETE VALLEJO MEMORIAL SCHOLARSHIP FOUNDATION

Field Data
EIN 47-2849566
Case Number EO-2015030-000518
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PETE VALLEJO MEMORIAL SCHOLARSHIP FOUNDATION
Organization’s Mailing Address 4561 HEIL AVE APT 22
City HUNTINGTON BEACH
State CA
ZIP 92649
Accounting period End 7
Primary contact name AISHAH S AL SEHAIM
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MARIA BURWELL
BOARD OF DIRECTORS
19030 SUMMIT RIDGE DRIVE
WALNUT CA 91789

Officer/Director/Trustee Two

REBECCA VALLEJO
BOARD OF DIRECTORS
4561 HEIL AVE APT 22
HUNTINGTON BEACH CA 92649

Officer/Director/Trustee Three

AISHAH AL-SEHAIM
BOARD OF DIRECTORS
4561 HEIL AVE APT 22
HUNTINGTON BEACH CA 92649

Officer/Director/Trustee Four

DAVID BURWELL
BOARD OF DIRECTORS
1472 HILLTOP LANE
NORCO CA 92860

Officer/Director/Trustee Five

DENISE BLACK
BOARD OF DIRECTORS
1090 HARRIS AVE
BOSQUE FARMS NM 87068

Organization’s website N/A
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/1/2015
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B12 - Fund Raising and/or Fund Distribution
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 Yes
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
Signature Title
Signature Date

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