FORM 1023-EZ for JASENOVAC MEMORIALS

Field Data
EIN 81-5237717
Case Number EO-2018026-000361
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name JASENOVAC MEMORIALS
Organization’s Mailing Address 1607 N HOLLOW DR
City HUMBLE
State TX
ZIP 77396
Accounting period End 12
Primary contact name ALEX POLLAK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ALEX POLLAK
PRESIDENT
1607 N HOLLOW DR
HUMBLE TX 77396

Officer/Director/Trustee Two

MARY POLLAK
SECRETARY
1607 N HOLLOW DR
HUMBLE TX 77396

Officer/Director/Trustee Three

LARRY KREJCI
TREASURER
127 NOVEL DEERLAKE RD
HUFFMAN TX 77336

Officer/Director/Trustee Four

SCOTT M GREEN
VICE PRESIDENT
12345 LANGWORTH LANE
HOUSTON TX 77024

Officer/Director/Trustee Five

RAY ATKINSON
BOARD MEMBER
1611 NORTH HOLLOW DRIVE
HUMBLE TX 77396

Organization’s website LESSONSFROMJASENOVAC.ORG
Organization’s email APOLLAK@PDQ.NET
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/27/17
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A54 - History Museums
Organization’s purpose Charitable: Yes
Religious: Yes
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name ALEX POLLAK
Signature Title PRESIDENT
Signature Date 1/24/18

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