FORM 1023-EZ for FOCS 4077 INC

Field Data
EIN 84-2697025
Case Number EO-2019226-000460
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name FOCS 4077 INC
Organization’s Mailing Address 6513 N BEACH ST
City FORT WORTH
State TX
ZIP 76137
Accounting period End 12
Primary contact name HOLLY PILS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

HOLLY PILS
OFFICER
6209 PRICE DR
NORTH RICHLAND HILLS TX 76180

Officer/Director/Trustee Two

COLLEEN SCHIERMEYER
OFFICER
2329 LOS OLIVOS LANE
FORT WORTH TX 76131

Officer/Director/Trustee Three

JEFF COX
OFFICER
5720 TABLE ROCK DR
FORT WORTH TX 76131

Organization’s website
Organization’s email HYPILS@AOL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/1/19
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O41 - Boy Scouts of America
Organization’s purpose Charitable: No
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) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name HOLLY PILS
Signature Title OFFICER
Signature Date 8/12/19

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