FORM 1023-EZ for CONNOR RAY MERTZ LAW ENFORCEMENT SCHOLARSHIP

Field Data
EIN 83-1215365
Case Number EO-2018239-000831
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CONNOR RAY MERTZ LAW ENFORCEMENT SCHOLARSHIP
Organization’s Mailing Address 475 HIGHLAND HILL RD
City LEHIGHTON
State PA
ZIP 18235
Accounting period End 12
Primary contact name STEVEN MERTZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

STEVEN MERTZ
CHAIRMAN
475 HIGHLAND HILL RD
LEHIGHTON PA 18235

Officer/Director/Trustee Two

SARAH HORNE
VICE-CHAIRMAN
475 HIGHLAND HILL RD
LEHIGHTON PA 18235-9576

Officer/Director/Trustee Three

DIXON CARRICK
TREASURER
475 HIGHLAND HILL RD
LEHIGHTON PA 18235

Officer/Director/Trustee Four

CLARA CARRICK
SECRETARY
475 HIGHLAND HILL RD
LEHIGHTON PA 18235

Officer/Director/Trustee Five

DEB BENO
BOARD MEMBER
3613 SOUTH CONCORDIA AVE
TAMPA FL 33629

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/30/18
Organization Incorporation State PA
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name STEVEN MERTZ
Signature Title CHAIRMAN
Signature Date 8/24/18

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