FORM 1023-EZ for HERITAGE HOUSE CENTER GROUP

Field Data
EIN 81-0819620
Case Number EO-2016309-000282
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HERITAGE HOUSE CENTER GROUP
Organization’s Mailing Address PO BOX 23
City SMITH
State NV
ZIP 89430
Accounting period End 12
Primary contact name RALPH MANTZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

WILLIS LAPHAM
PRESIDENT
36 RIVERS ROAD
SMITH NV 89430

Officer/Director/Trustee Two

NICHOLEE KUSMICKI
VICE- PRESIDENT
797 ROJO ROAD
GARDNERVILLE NV 89460-7577

Officer/Director/Trustee Three

RALPH MANTZ
TREASURER
PO BOX 166
SMITH NV 89430-0166

Officer/Director/Trustee Four

RUTH MUNCY
SECRETARY
295 ARTIST VIEW DRIVE
WELLINGTON NV 89444

Officer/Director/Trustee Five

KATHERINE FEASTER
DIRECTOR
24 LODGEPOLE ROAD
WELLINGTON NV 89444

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/19/2010
Organization Incorporation State NV
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P81 - Senior Centers, Services
Organization’s purpose Charitable: Yes
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 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
Signature Title
Signature Date

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