FORM 1023-EZ for MISS CLARK COUNTY SCHOLARSHIP FOUNDATION

Field Data
EIN 83-1230910
Case Number EO-2018199-000179
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MISS CLARK COUNTY SCHOLARSHIP FOUNDATION
Organization’s Mailing Address 715 NW 151ST STREET
City VANCOUVER
State WA
ZIP 98685
Accounting period End 7
Primary contact name SHERI BACKOUS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHERI BACKOUS
PRESIDENT
715 NW 151ST ST
VANCOUVER WA 98685

Officer/Director/Trustee Two

SAMANTHA BALLOU
VICE PRESIDENT
3620 NE 143RD AVENUE
VANCOUVER WA 98682

Officer/Director/Trustee Three

ONNOLEE SCHELL
SECRETARY
7908 NW 9TH AVENUE
VANCOUVER WA 98665

Officer/Director/Trustee Four

LINDA TRACY
TREASURER
530 E 17TH CIRCLE
LA CENTER WA 98629

Officer/Director/Trustee Five

KAREN MORLEY-SMITH
LADIES DIRECTOR
10507 NE 91ST AVENUE
VANCOUVER WA 98662

Organization’s website
Organization’s email MCCSFOUNDATION@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/17/15
Organization Incorporation State WA
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: 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 SHERI BACKOUS
Signature Title PRESIDENT
Signature Date 7/16/18

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