FORM 1023-EZ for MOUNT HOREB YOUTH CENTER INC

Field Data
EIN 45-5558011
Case Number EO-2015351-000299
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MOUNT HOREB YOUTH CENTER INC
Organization’s Mailing Address 105 NORTH GROVE STREET
City MOUNT HOREB
State WI
ZIP 53572
Accounting period End 12
Primary contact name MICHAEL PHARO
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MICHAEL PHARO
PRESIDENT / TREASURE / DIRECTOR
2235 COUNTY ROAD JG
MOUNT HOREB WI 53572

Officer/Director/Trustee Two

BRENDA FRITZ
SECRETARY / DIRECTOR
116 MARSHALL COURT
MOUNT HOREB WI 53572

Officer/Director/Trustee Three

STEPHANIE BEADLE
DIRECTOR
311 TVEDT DRIVE
MOUNT HOREB WI 53572

Officer/Director/Trustee Four

LISA DUFFY
DIRECTOR
600 ETHAN TERRACE
VERONA WI 53593

Officer/Director/Trustee Five

JASON ANDERSON
DIRECTOR
2994 CAVE OF THE MOUNDS ROAD
BLUE MOUNDS WI 53517

Organization’s website WWW.MTHOREBYC.NET
Organization’s email MPHARO@MTHOREBYC.NET
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/11/2012
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O20 - Youth Centers, Clubs, Multipurpose
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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