FORM 1023-EZ for HOMERINE BODEN SCHOLARSHIP

Field Data
EIN 47-3694518
Case Number EO-2015119-000397
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HOMERINE BODEN SCHOLARSHIP
Organization’s Mailing Address 728 KLEIN CIR
City DERBY
State KS
ZIP 67037
Accounting period End 12
Primary contact name SANDRA BODEN CUSACK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JACK BODEN
TRUSTEE
728 KLEIN CIR
DERBY KS 67037

Officer/Director/Trustee Two

SANDRA BODEN CUSACK
TRUSTEE
601 N WOODRIDGE ST
WICHITA KS 67206

Organization’s website
Organization’s email RSQSACK@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/22/2015
Organization Incorporation State KS
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 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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