FORM 1023-EZ for HICKORY HOUSE FELLOWSHIP CHAPEL

Field Data
EIN 61-1947288
Case Number EO-2019301-000384
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HICKORY HOUSE FELLOWSHIP CHAPEL
Organization’s Mailing Address 12526 APPLE ROAD
City WHITEWOOD
State SD
ZIP 57793-6438
Accounting period End 12
Primary contact name ALAN LOKEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ALAN LOKEN
PRESIDENT
12526 APPLE RD
WHITEWOOD SD 57793

Officer/Director/Trustee Two

MARLA LOKEN
VICE PRESIDENT
12526 APPLE RD
WHITEWOOD SD 57793

Officer/Director/Trustee Three

ARLENE BOWMAN
SECRETARY/TREASURER
2173 CONIFER LOOP
BELLE FOURCHE SD 57717

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/2/19
Organization Incorporation State SD
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T50 - Philanthropy, Charity, Voluntarism Promotion, General
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 ALAN LOKEN
Signature Title PRESIDENT
Signature Date 10/24/19

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