FORM 1023-EZ for BRAD STAPLEY MEMORIAL FOUNDATION

Field Data
EIN 84-2490027
Case Number EO-2019214-000180
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BRAD STAPLEY MEMORIAL FOUNDATION
Organization’s Mailing Address 1148 EAST BIRKEN
City ST GEORGE
State UT
ZIP 84780
Accounting period End 12
Primary contact name JANA STAPLEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JANA STAPLEY
PRESIDENT
1148 EAST BIRKEN
ST GEORGE UT 84780-8341

Officer/Director/Trustee Two

AARON STAPLEY
VICE PRESIDENT
2679 S 3160 E
ST GEORGE UT 84790-1787

Officer/Director/Trustee Three

DEVON STAPLEY
VICE PRESIDENT
3882 S 2640 E
ST GEORGE UT 84790-5059

Officer/Director/Trustee Four

KELLI CHARLTON
PRESIDENT ELECT
4336 W MARTIN ST
HURRICANE UT 84737-7723

Officer/Director/Trustee Five

BENJAMIN HULET
TREASURE
2444 S ARABIAN WAY
WASHINGTON UT 84780-8341

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/23/19
Organization Incorporation State UT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E99 - Health - General and Rehabilitative N.E.C.
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 JANA STAPLEY
Signature Title PRESIDENT
Signature Date 7/31/19

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