FORM 1023-EZ for LIVE LIKE LEEROY SCHOLARSHIP FUND INC

Field Data
EIN 82-3774148
Case Number EO-2021085-001048
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LIVE LIKE LEEROY SCHOLARSHIP FUND INC
Organization’s Mailing Address PO BOX 554
City WINK
State TX
ZIP 79789
Accounting period End 12
Primary contact name RANDY J GRAHAM
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RANDY GRAHAM
SERETARY
14 WINDING WAY STREET
PECOS TX 79772

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/21/2017
Organization Incorporation State TX
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name RANDY GRAHAM
Signature Title SERETARY
Signature Date 2/5/2021
EIN 82-3774148
Case Number EO-2018012-000257
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LIVE LIKE LEEROY SCHOLARSHIP FUND INC
Organization’s Mailing Address PO BOX 82
City WINK
State TX
ZIP 79789
Accounting period End 12
Primary contact name CLAY FERNANDEZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CLAY FERNANDEZ
PRESIDENT
404 N RODGERS
PYOTE TX 79777

Officer/Director/Trustee Two

KAMA SLAUGHTER
V/P
323 N WEST 1ST ST
WINK TX 79789

Officer/Director/Trustee Three

CHAD EVANS
DIRECTOR
925 E WINKLER
KERMIT TX 79745

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/20/17
Organization Incorporation State TX
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: 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 CLAY FERNANDEZ
Signature Title PRESIDENT
Signature Date 1/10/18

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