FORM 1023-EZ for BRAD FOX MEMORIAL 5K FOUNDATION

Field Data
EIN 46-1111778
Case Number EO-2016239-000231
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BRAD FOX MEMORIAL 5K FOUNDATION
Organization’s Mailing Address 3395 ARCOLA ROAD
City COLLEGEVILLE
State PA
ZIP 19426
Accounting period End 12
Primary contact name DEANNA KOZAK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DEANNA KOZAK
EXECUTIVE DIRECTOR
3395 ARCOLA ROAD
COLLEGEVILLE PA 19426

Officer/Director/Trustee Two

MONICA MONAGHAN
SECRETARY
3720 W MILL ROAD
HATBORO PA 19040

Officer/Director/Trustee Three

KIMBERLY JACKSON
TREASURER
1408 SANDWOOD ROAD
CONSHOHOCKEN PA 19428

Organization’s website WWW.FOXSTROT5K.COM
Organization’s email BRADFOXMEMORIAL5K@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/3/2012
Organization Incorporation State PA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Z99 - Unclassified
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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