FORM 1023-EZ for ZION STATE LINE LUTHERAN CHURCH CEMETERY INC

Field Data
EIN 83-1551919
Case Number EO-2018255-000136
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ZION STATE LINE LUTHERAN CHURCH CEMETERY INC
Organization’s Mailing Address 213 S SANTA FE AVENUE
City SALINA
State KS
ZIP 67402-2388
Accounting period End 12
Primary contact name KENNETH W WASSERMAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RUSSELL HENNERBERG
PRESIDENT
2934 THUNDER ROAD
HOLLENBERG KS 66946

Officer/Director/Trustee Two

CALVIN HENNERBERG
VICE PRESIDENT
57860 HIGHWAY 8
STEELE CITY NE 68440

Officer/Director/Trustee Three

RANDY SAATHOFF
SECRETARY
70425 580TH AVENUE
DILLER NE 68342

Officer/Director/Trustee Four

ROBERT KNOOP
TREASURER
2961 VICTORY ROAD
HOLLENBERG KS 66946

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/15/18
Organization Incorporation State KS
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Y50 - Cemeteries, Burial Services
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 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 RUSSELL HENNERBERG
Signature Title PRESIDENT
Signature Date 9/10/18

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