FORM 1023-EZ for SUSAN STOVCIK MEMORIAL FOUNDATION

Field Data
EIN 84-4529642
Case Number EO-2020049-000613
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SUSAN STOVCIK MEMORIAL FOUNDATION
Organization’s Mailing Address 18361 WALNUT DR
City STRONGSVILLE
State OH
ZIP 44149
Accounting period End 12
Primary contact name ERICA STARK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

HAYLEY STOVCIK
PRESIDENT
18361 WALNUT DR
STRONGSVILLE OH 44149

Officer/Director/Trustee Two

WAYNE STOVCIK
VICE PRESIDENT
18361 WALNUT DR
STRONGSVILLE OH 44149

Officer/Director/Trustee Three

COLLEEN SPORAR
2ND VICE PRESIDENT
7651 EDGEWOOD LN
SVENE HILLS OH 44131

Officer/Director/Trustee Four

MICHAEL POTIRAKIS
SECRETARY
9771 SUNRISE BLVD N2
NORTH ROYALTON OH 44133

Officer/Director/Trustee Five

BARBARA ROSLAN
BOARD MEMBER
7365 CAMELOT DR
PARMA OH 44134

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/20/2020
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A12 - 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 Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name HAYLEY STOVCIK
Signature Title PRESIDENT
Signature Date 2/15/2020

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