FORM 1023-EZ for CANCELMO COUSINS FUND

Field Data
EIN 83-3646925
Case Number EO-2019056-000465
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CANCELMO COUSINS FUND
Organization’s Mailing Address 222 WESTMORELAND ST
City HOUSTON
State TX
ZIP 77006
Accounting period End 12
Primary contact name A DENNEY CANCELMO
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DENNEY CANCELMO
DIRECTOR
222 WESTMORELAND ST
HOUSTON TX 77006

Officer/Director/Trustee Two

KRISTINA WALLACE-CANCELMO
DIRECTOR
222 WESTMORELAND ST
HOUSTON TX 77006

Officer/Director/Trustee Three

CATHY MOLCHAN
DIRECTOR
15 HIGHVIEW RD
RADNOR PA 19087

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/5/19
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E12 - 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 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 DENNEY CANCELMO
Signature Title DIRECTOR
Signature Date 2/22/19

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