FORM 1023-EZ for PELLA YOUTH COALITION

Field Data
EIN 83-1925358
Case Number EO-2018267-000336
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PELLA YOUTH COALITION
Organization’s Mailing Address 407 PEACE STREET
City PELLA
State IA
ZIP 50219
Accounting period End 12
Primary contact name DAVID BEUKELMAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TRICIA VAN ZEE
DIRECTOR
2284 DAKOTA WOOD DRIVE
PELLA IA 50219

Officer/Director/Trustee Two

JOHN AMELSE
DIRECTOR
1020 MEADOW CREST DRIVE
PELLA IA 50219

Officer/Director/Trustee Three

DAVID BEUKELMAN
DIRECTOR
407 PEACE STREET
PELLA IA 50219

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/18/18
Organization Incorporation State IA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F21 - Alcohol, Drug Abuse, Prevention Only
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 Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name DAVID BEUKELMAN
Signature Title DIRECTOR
Signature Date 9/21/18

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