FORM 1023-EZ for ERIKA NIEDOWSKI MEMORIAL SCHOLARSHIP

Field Data
EIN 85-4038115
Case Number EO-2021019-000158
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ERIKA NIEDOWSKI MEMORIAL SCHOLARSHIP
Organization’s Mailing Address 78 BOULEVARD AVE
City LINCOLN
State RI
ZIP 02865-2028
Accounting period End 12
Primary contact name PATRICK LAVERTY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PATRICK LAVERTY
DIRECTOR
78 BOULEVARD AVE
LINCOLN RI 02865-2028

Officer/Director/Trustee Two

RAYMOND NIEDOWSKI
DIRECTOR
PO BOX 518
MARSHFIELD HILLS MA 02051-0518

Officer/Director/Trustee Three

MARION NIEDOWSKI
DIRECTOR
PO BOX 518
MARSHFIELD HILLS MA 02051-0518

Officer/Director/Trustee Four

NANCY WELSH
DIRECTOR
47 HOLMES DALE
ALBANY NY 12203-2022

Officer/Director/Trustee Five

DON WELSH
DIRECTOR
47 HOLMES DALE
ALBANY NY 12203-2022

Organization’s website erikaniedowski.org
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/23/2020
Organization Incorporation State RI
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: Yes
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 No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name PATRICK LAVERTY
Signature Title DIRECTOR
Signature Date 11/25/2020

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