FORM 1023-EZ for KRISTIN MARIE PROVOAST MEMORIAL SCHOLARSHIP FUND

Field Data
EIN 82-4259293
Case Number EO-2018107-000690
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name KRISTIN MARIE PROVOAST MEMORIAL SCHOLARSHIP FUND
Organization’s Mailing Address 610 CAMPBELL ROAD
City WEST BRANCH
State MI
ZIP 48661
Accounting period End 12
Primary contact name MICHELLE PARLIAMENT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MICHELLE PARLIAMENT
PRESIDENT
610 CAMPBELL ROAD
WEST BRANCH MI 48661

Officer/Director/Trustee Two

JEREMY TENNANT
VICE PRESIDENT
5857 WEST M76
WEST BRANCH MI 48661

Officer/Director/Trustee Three

KIM KLANN
SECRETARY
4258 TEE LAKE ROAD
WEST BRANCH MI 48661

Officer/Director/Trustee Four

MICHELLE TENNANT
TREASURER
5857 WEST M76
WEST BRANCH MI 48661

Officer/Director/Trustee Five

JOE ZIMMER
TRUSTEE
2630 POINTER ROAD
WEST BRANCH MI 48661

Organization’s website
Organization’s email KMPROVOAST@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/1/17
Organization Incorporation State MI
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: 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 No
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 Yes
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 MICHELLE PARLIAMENT
Signature Title PRESIDENT
Signature Date 3/27/18

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