FORM 1023-EZ for MASON JAYCE FOUNDATION

Field Data
EIN 61-1843697
Case Number EO-2017289-000369
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MASON JAYCE FOUNDATION
Organization’s Mailing Address 709 MAYFAIR PLACE
City ROCK HILL
State SC
ZIP 29730
Accounting period End 12
Primary contact name TAMMY ELMORE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TAMMY ELMORE
CHIEF EXECUTIVE OFFICER
709 MAYFAIR PL
ROCK HILL SC 29730

Officer/Director/Trustee Two

JAMES ELMORE
CHIEF FINANCIAL OFFICER
709 MAYFAIR PL
ROCK HILL SC 29730

Officer/Director/Trustee Three

STEVEN ELMORE
CHAIRPERSON
709 MAYFAIR PL
ROCK HILL SC 29730

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/20/2017
Organization Incorporation State SC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P30 - Children's, Youth Services
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 Yes
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 No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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