FORM 1023-EZ for HERSHEY LIONS CLUB FOUNDATION

Field Data
EIN 47-2353134
Case Number EO-2014324-000350
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HERSHEY LIONS CLUB FOUNDATION
Organization’s Mailing Address 112 DOVE COURT
City HUMMELSTOWN
State PA
ZIP 17036
Accounting period End 6
Primary contact name ROBERT E WATKINS JR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

CLIFFORD A PASSUELLO
PRESIDENT
1147 JILL DR
HUMMELSTOWN PA 17036-9022

Officer/Director/Trustee Two

ROBERT E WATKINS JR
TREASURER
112 DOVE COURT
HUMMELSTOWN PA 17036

Officer/Director/Trustee Three

PETER R VAN ZANDT
PAST PRESIDENT
900 HARNISH ST
PALMYRA PA 17078

Officer/Director/Trustee Four

BRIAN LYNCH
DIRECTOR
741 WHEATSTONE DR
PALMYRA PA 17078

Officer/Director/Trustee Five

BART CALLEAR
DIRECTOR
146 S 2ND STREET
DILLSBURG PA 17019

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/6/2014
Organization Incorporation State PA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P12 - Fund Raising and/or Fund Distribution
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
Signature Title
Signature Date

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