FORM 1023-EZ for JARAD GROHOWSKI FOUNDATION

Field Data
EIN 20-5060047
Case Number EO-2016165-000397
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name JARAD GROHOWSKI FOUNDATION
Organization’s Mailing Address 125 ALMOND LANE
City WILKES-BARRE
State PA
ZIP 18702
Accounting period End 7
Primary contact name BRIAN GROHOWSKI
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

BRIAN GROHOWSKI
PRESIDENT / DIRECTOR
125 ALMOND LANE
WILKES-BARRE PA 18702

Officer/Director/Trustee Two

THADDEUS RICHARDS
VP / DIRECTOR
1179 CARMARTA DRIVE
PITTSBURGH PA 15227

Officer/Director/Trustee Three

MAUREEN GROHOWSKI
SECRETARY / DIRECTOR
125 ALMOND LANE
WILKES-BARRE PA 18702

Officer/Director/Trustee Four

ROSS WAYMAN
TREASURER / DIRECTOR
468 NEW MARKET STREET
WILKES-BARRE PA 18702

Officer/Director/Trustee Five

MARK GROHOWSKI
DIRECTOR
14 OAK LANE
ASHLEY PA 18706

Organization’s website WWW.JARADFOUNDATION.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/9/2016
Organization Incorporation State PA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P01 - Alliance/Advocacy Organizations
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 Yes
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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