FORM 1023-EZ for ROBERT K MAYBERRY JR FOUNDATION

Field Data
EIN 30-0697867
Case Number EO-2015008-000162
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ROBERT K MAYBERRY JR FOUNDATION
Organization’s Mailing Address 4019 AKOCHIA AVE
City CINCINNATI
State OH
ZIP 45205
Accounting period End 12
Primary contact name ROBERT K MAYBERRY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ROBERT MAYBERRY
DIRECTOR
4019 AKOCHIA AVE
CINCINNATI OH 45205

Officer/Director/Trustee Two

CHARLES SMITH
PROGRAM DIRECTOR
2704 NORTHBEND RD
CINCINNATI OH 45239

Officer/Director/Trustee Three

SHEILA WARD
DIRECTOR OF FINANCE
4019 AKOCHIA AVE
CINCINNATI OH 45205

Organization’s website WWW.RKMJRFOUNDATION.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/22/2011
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T20 - Private Grantmaking Foundations
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 Yes
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 Yes
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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