FORM 1023-EZ for PBMAH SCHOLARSHIP FUND

Field Data
EIN 83-2134598
Case Number EO-2018305-000204
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PBMAH SCHOLARSHIP FUND
Organization’s Mailing Address 180 KIRKALDY DR
City HOUSTON
State TX
ZIP 77015
Accounting period End 12
Primary contact name KIMBERLY BROOKS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KIMBERLY BROOKS
DIRECTOR
180 KIRKALDY DR
HOUSTON TX 77015

Officer/Director/Trustee Two

DARCY HARPER
TREASURER
7543 WELSHSTONE LN
HOUSTON TX 77049

Officer/Director/Trustee Three

ROSA CARROLL
SECRETARY
1701 BREWSTER 03
HOUSTON TX 77020

Organization’s website
Organization’s email KIMROB@PBMAH.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/10/18
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 KIMBERLY BROOKS
Signature Title DIRECTOR
Signature Date 10/30/18

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