2026-04-23T15:08:44-05:00 2025-06-30 521446779 JOHNSON LAMBERT LLP 4242 SIX FORKS ROAD SUITE 1500 RALEIGH NC 27609 990PF 2024-07-01 050473536 RHODE ISLAND CPCU SCHOLARSHIP FUND RHOD 8006526422 CO AMICA 100 AMICA WY LINCOLN RI 02865 STEFVAN DREZEK TREASURER 8006526422 2026-04-23 1 1 ANDREW HASSLER P02469039 9197196400 2024 2025-03-06 01:10:19Z X 1444927 X 7166 30615 30615 100611 134932 100611 138392 131226 0 0 0 3000 750 2250 6000 0 0 9498 1346 8152 18498 2096 10402 75000 70000 93498 2096 80402 44894 129130 15463 9130 9130 1357331 1435797 1435797 1372794 1444927 1444927 0 0 X 1372794 1444927 1372794 1444927 1372794 1444927 1372794 44894 27239 1444927 0 1444927 CAPITAL GAIN - SALE OF MUTUAL FUND 80000 34321 45679 45679 CAPITAL GAIN DISTRIBUTION - MUTUAL FUND 54932 54932 54932 100611 1795 0 1795 0 1795 1306 0 518 0 1824 0 29 29 0 0 0 0 0 0 0 0 0 0 0 1 1 RI 0 0 0 0 0 1 RICPCUSCHOLARSHIP.COM STEFVAN DREZEK 8006526422 C/O AMICA 100 AMICA WY LINCOLN RI 02865 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 BRIAN A RUSATE C/O AMICA 100 AMICA WY LINCOLN NE 02865 PRESIDENT 0.00 0 0 0 STEFVAN DREZEK C/O AMICA 100 AMICA WY LINCOLN NE 02865 TREASURER 0.00 0 0 0 MICHELLE N PELLETIER C/O AMICA 100 AMICA WY LINCOLN NE 02865 SECRETARY 0.00 0 0 0 TRACI ADEDEJI C/O AMICA 100 AMICA WY LINCOLN NE 02865 DIRECTOR (TO SEP '24) 0.00 0 0 0 DAVID E FALES C/O AMICA 100 AMICA WY LINCOLN NE 02865 DIRECTOR 0.00 0 0 0 TODD R LARSON C/O AMICA 100 AMICA WY LINCOLN NE 02865 DIRECTOR 0.00 0 0 0 ALLAN MCDERMOTT C/O AMICA 100 AMICA WY LINCOLN NE 02865 DIRECTOR 0.00 0 0 0 JOHN C TICKNER C/O AMICA 100 AMICA WY LINCOLN NE 02865 DIRECTOR 0.00 0 0 0 NONE 0 NONE 0 PROVIDE SCHOLARSHIPS TO INDIVIDUALS ASSOCIATED WITH THE INSURANCE INDUSTRY IN ACCORDANCE WITH ELIGIBILITY GUIDELINES. THIS YEAR, THE FUND AWARDED 14 SCHOLARSHIPS. 93498 0 1390222 50686 0 1440908 0 0 1440908 21614 1419294 70965 70965 1795 1795 69170 0 69170 0 69170 80402 0 80402 69170 5467 0 0 80402 5467 0 0 69170 5765 0 0 5765 0 0 0 0 0 0 0 5765 5765 BRIAN RUSATE 100 AMICA WY LINCOLN RI 02865 8006526422 BASIC BIOGRAPHICAL INFORMATION; CONNECTION TO THE INSURANCE INDUSTRY; EDUCATIONAL INSTUTUTION CURRENTLY ATTENDED AND STATUS; PRIOR SCHOLASTIC EXCELLENCE RECOGNITION; EXPLANATION OF HOW PRESENT AND RECENT GRADES REFLECT ONE'S COMMITMENT TO EDUCATION ADVANCEMENT AND CAREER ASPIRATIONS; EXPLANATION OF MEANINGFUL EXTRA-CURRICULAR SCHOOL ACTIVITIES AND LEADERSHIP ROLES HELD; EXPLANATION OF ORGANIZATIONS IN WHICH ONE HAS BEEN ACTIVE, INCLUDING LEADERSHIP ROLES; CERTIFICATIONS ATTAINED; CAREER ASPIRATIONS; PERSONAL STATEMENT AS TO WHY ONE IS DESERVING OF THE SCHOLARSHIP; REFERENCES; EMPLOYMENT INFORMATION; SCHOOLS APPLIED TO AND ACCEPTANCE STATUS; TRANSCRIPT, SAT SCORES, AND ANY OTHER INFORMATION DEEMED RELEVANT. MARCH 31ST EACH YEAR. TO BE ELIGIBLE THE APPLICANT MUST: A. BE WORKING IN THE INSURANCE INDUSTRY IN RHODE ISLAND OR WORKING IN THE INSURANCE INDUSTRY ELSEWHERE AND BE A RESIDENT OF RHODE ISLAND, OR AN ACTIVE MEMBER OF THE RI CHAPTER CPCU, OR; BE A SPOUSE, CHILD, SIBLING, PARENT, GRANDPARENT, GRANDCHILD, OR STEPCHILD OF A PERSON WHO IS EITHER WORKING IN THE INSURANCE INDUSTRY IN RHODE ISLAND OR WHO IS WORKING ELSEWHERE IN THE INSURANCE INDUSTRY AND IS A RESIDENT OF RHODE ISLAND, OR AN ACTIVE MEMBER OF THE RI CHAPTER CPCU; AND BE ENROLLED AT AN ACCREDITED TWO OR FOUR YEAR COLLEGE OR UNIVERSITY IN A FULL TIME ASSOCIATE'S DEGREE OR BACHELOR'S DEGREE PROGRAM; AND NOT HAVE BEEN AWARDED THIS SCHOLARSHIP IN THE PAST. PRIOR UNSUCCESSFUL CANDIDATES MAY REAPPLY. RAJEEV SEN 460 FIRST AVENUE EAST GREENWICH RI 02818 N/A I SCHOLARSHIP 7000 AATHITYAN JAYARAJAN 87 HIGHWOOD DR FRANKLIN MA 02038 N/A I SCHOLARSHIP 6500 KEIRA EVANS 160 WARREN DRIVE NORFOLK MA 02056 N/A I SCHOLARSHIP 6000 VIGNESH PEDDI BROWN UNI 69 BROWN ST MAIL 8135 PROVIDENCE RI 02912 N/A I SCHOLARSHIP 5500 ELIZABETH VITALE 34 TOBIN LANE BRISTOL RI 02809 N/A I SCHOLARSHIP 5000 JAYCI TICKNER 48 VIRGINA AVENUE EAST GREENWICH RI 02818 GRANDCHILD OF DIRECTOR I SCHOLARSHIP 5000 DEVON FRAENZA 2 ROSE BUSH CIRCLE CRANSTON RI 02921 N/A I SCHOLARSHIP 5000 AVERY LOUGH 768 BLACK PLAIN ROAD NORTH SMITHFIELD RI 02896 N/A I SCHOLARSHIP 5000 MADELYN MCINNIS 223 VERMONT AVENUE PROVIDENCE RI 02905 N/A I SCHOLARSHIP 5000 ARDEN WILKES 697 HOPE STREET BRISTOL RI 02809 N/A I SCHOLARSHIP 5000 NATHANIEL JOHNSON 54 LORIMER AVENUE PROVIDENCE RI 02906 N/A I SCHOLARSHIP 5000 REBECCA KELMAN 19 SAINT JAMES LANE NORTH SCITUATE RI 02857 N/A I SCHOLARSHIP 5000 SASHA MCNANEY 19 ALEXSANDRIA DR MEDWAY MA 02053 N/A I SCHOLARSHIP 5000 VICTORIA SOUSA 82 HEATH STREET RIVERSIDE RI 02915 N/A I SCHOLARSHIP 5000 75000 0 14 30615 18 100611 0 131226 0 131226 0 0 0 0 0 0 0 0 0 0 X X 1 THE BEACON FOUNDATION ONE BEACON CENTRE WARWICK RI 02886 5000 X 3000 750 2250 UNDER RHODE ISLAND LAW, THE RHODE ISLAND SCHOLARSHIP FUND IS NOT REQUIRED TO FURNISH A COPY OF ITS 990-PF FILING TO THE ATTORNEY GENERAL FOR THE STATE OF RHODE ISLAND. FORM 990-PF, PART VI-B, LINE 5B: THE RHODE ISLAND CPCU SCHOLARSHIP FUND (THE FUND) BECAME AWARE, PRIOR TO THE END OF THE TAX YEAR, OF THE NEED TO SEEK ADVANCE APPROVAL FROM THE IRS FOR THE FUND'S SCHOLARSHIP GRANT MAKING PROCEDURES. WHILE THE FUND RECENTLY BECAME A PRIVATE FOUNDATION, THE PROCEDURES WERE DEVELOPED AND THE PROGRAM RUN FOR MANY YEARS WHILE THE FUND WAS A PUBLIC CHARITY DESCRIBED IN 170(B)(1)(A)(VI). UPON BECOMING AWARE OF THE NEED TO SEEK ADVANCE APPROVAL, THE FUND PROMPTLY REQUESTED APPROVAL VIA SUBMISSION OF FORM 8940 TO THE IRS. SUBMISSION OCCURED PRIOR TO THE END OF THE TAX YEAR, BUT AFTER SCHOLARSHIPS WERE ISSUED TO INDIVIDUALS FOR THE TAX YEAR ENDING JUNE 30, 2025. THE FUND HAS RECEIVED ADVANCE APPROVAL AS OF MARCH 2, 2026.THE FUND BELIEVES THEY QUALIFY FOR RELIEF FROM TAX ON THESE SCHOLARSHIP EXPENDITURES UNDER THE PROVISIONS OF 26 CFR 53.4945-1(D)(3). THE FUND HAS MADE A REASONABLE EFFORT TO CONFIRM FROM GRANT RECIPIENTS THAT NO GRANT FUNDS HAVE BEEN DIVERTED TO ANY USE NOT IN FURTHERANCE OF A PURPOSE SPECIFIED IN THE GRANT; AND AFFIRMS THAT NO FUNDS WERE DIVERTED TO THE BEST OF THEIR KNOWLEDGE.THE FUND BELIEVES THE GRANT MAKING PROCEDURES INSTITUTED WOULD HAVE BEEN APPROVED IF ADVANCE APPROVAL OF SUCH PROCEDURES HAD BEEN PROPERLY REQUESTED. THE PROCEDURES HAVE SUBSEQUENTLY RECIEVED SUCH APPROVAL.THE FUND AFFIRMS THAT WHERE ADVANCE APPROVAL OF GRANT MAKING PROCEDURES IS SUBSEQUENTLY REQUIRED, SUCH APPROVAL WILL BE PROPERLY REQUESTED. VANGUARD BALANCED INDEX ADMIRAL CL FMV 1435797 1435797 SCHOLARSHIP BANQUET 4822 0 4822 WEBSITE 2434 0 2434 BOP AND FIDELITY 1125 1125 0 D&O INSURANCE 885 221 664 JUDGE'S LUNCHEON/GIFT BASKETS 226 0 226 OTHER (STATE FILING FEE, POSTAGE, PO BOX) 6 0 6 UNREALIZED GAINS 27239 NET INVESTMENT INCOME TAX 6000 0 0