FORM 1023-EZ for SHELBY COUNTY CANCER FUND

Field Data
EIN 82-5063277
Case Number EO-2018157-000157
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SHELBY COUNTY CANCER FUND
Organization’s Mailing Address 1039 CR 2450
City SHELBYVILLE
State TX
ZIP 75973
Accounting period End 12
Primary contact name STACY OREAR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

STACY OREAR
PRESIDENT
1039 CR 2450
SHELBYVILLE TX 75973

Officer/Director/Trustee Two

SHARON BAKER
V-PRESIDENT
886 CR RD 2572
CENTER TX 75935

Officer/Director/Trustee Three

SHANI OSWALT
SECRETARY
1960 CR 2450
SHELBYVILLE TX 75973

Officer/Director/Trustee Four

LADONNA KENNON
TREASURER
474 CR 2026
CENTER TX 75935

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/7/18
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P12 - Fund Raising and/or Fund Distribution
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 STACY OREAR
Signature Title PRESIDENT
Signature Date 6/4/18

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