FORM 1023-EZ for JASON ROSELIUS MEMORIAL FOUNDATION

Field Data
EIN 82-5475336
Case Number EO-2019058-000413
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name JASON ROSELIUS MEMORIAL FOUNDATION
Organization’s Mailing Address PO BOX 51149
City AMARILLO
State TX
ZIP 79159
Accounting period End 12
Primary contact name ELIZABETH C NICHOLS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LIZ HUGHES
DIRECTOR
PO BOX 51149
AMARILLO TX 79159

Officer/Director/Trustee Two

BRANDON WOOD
OFFICER
2702 CASAS DEL SUR CT
GRANDBURY TX 76049

Officer/Director/Trustee Three

MICHAEL MANKIN
OFFICER
PO BOX 541031
DALLAS TX 75354

Officer/Director/Trustee Four

SEAN HANDLER
OFFICER
280 KING OF PRUSSIA ROAD
RADNOR PA 19087

Officer/Director/Trustee Five

ELIZABETH NICHOLS
OFFICER
1401 NIGHTHAWK DR
EDMOND OK 73034

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/8/18
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 Yes
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name ELIZABETH NICHOLS
Signature Title OFFICER
Signature Date 2/25/19

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