FORM 1023-EZ for WAVERLY HISTORICAL SOCIETY INC

Field Data
EIN 47-1268218
Case Number EO-2015030-000563
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name WAVERLY HISTORICAL SOCIETY INC
Organization’s Mailing Address 823 WALKER HILL ROAD
City WAVERLY
State NY
ZIP 14892
Accounting period End 12
Primary contact name GREG MCRAY EA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

PATRICIA BRUNK
PRESIDENT / TREASURER
823 WALKER HILL ROAD
WAVERLY NY 14892

Officer/Director/Trustee Two

LINDA VOGEL
SECRETARY
610 S ELMER AVENUE
SAYRE PA 18840

Officer/Director/Trustee Three

DOUG VANALLEN
DIRECTOR
690 WALKER HILL ROAD
WAVERLY NY 14892

Officer/Director/Trustee Four

DONALD MERRILL
DIRECTOR
535 WAVERLY STREET
WAVERLY NY 14892

Officer/Director/Trustee Five

RAYMOND CASE
DIRECTOR
470 PENNSYLVANIA AVENUE
WAVERLY NY 14892

Organization’s website NA
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/2/2015
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A80 - Historical Societies, Related Historical Activities
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
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 No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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