FORM 1023-EZ for KYSSI ANDREWS FOUNDATION FOR PEDIATRIC CANCER

Field Data
EIN 47-4782547
Case Number EO-2018346-000359
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name KYSSI ANDREWS FOUNDATION FOR PEDIATRIC CANCER
Organization’s Mailing Address PO BOX 840941
City HOUSTON
State TX
ZIP 77284
Accounting period End 12
Primary contact name MARLA JONES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MARLA JONES
FOUNDER/CEO
PO BOX 840941
HOUSTON TX 77284

Officer/Director/Trustee Two

DELLA MOTT
SECRETARY
19314 LAGUNA WOODS
TOMBALL TX 77375

Officer/Director/Trustee Three

BRUCE ALLEN
DIRECTOR
13706 WRIGLEY STREET
HOUSTON TX 77045

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/10/15
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E86 - Patient Services - Entertainment, Recreation
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name MARLA JONES
Signature Title FOUNDER/CEO
Signature Date 12/10/18

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