FORM 1023-EZ for LEROY AREA HISTORICAL SOCIETY

Field Data
EIN 47-5228055
Case Number EO-2019134-000040
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LEROY AREA HISTORICAL SOCIETY
Organization’s Mailing Address 407 S BROADWAY
City LEROY
State MN
ZIP 55951
Accounting period End 12
Primary contact name CRAIG JACOBSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ALICE KEMPE
PRESIDENT
407 S BROADWAY
LEROY MN 55951

Officer/Director/Trustee Two

LIZ OBYRNE
VICE PRESIDENT
407 S BROADWAY
LEROY MN 55951

Officer/Director/Trustee Three

DONNA JOHNSON
SECRETARY
407 S BROADWAY
LEROY MN 55951

Officer/Director/Trustee Four

SHARON GRASS
TREASUER
407 S BROADWAY
LEROY MN 55951

Officer/Director/Trustee Five

MICHELLE SCHROEDER
DIR
407 S B ROADWAY
LEROY MN 55951

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/2/15
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A50 - Museum, Museum Activities
Organization’s purpose Charitable: No
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name ALICE KEMPE
Signature Title PRESIDENT
Signature Date 5/10/19
EIN 47-5228055
Case Number EO-2015288-000137
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LEROY AREA HISTORICAL SOCIETY
Organization’s Mailing Address 407 S BROADWAY
City LEROY
State MN
ZIP 55951
Accounting period End 12
Primary contact name CRAIG JACOBSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ALICE KEMPE
PRESIDENT
407 S BROADWAY
LEROY MN 55951

Officer/Director/Trustee Two

DONNA JOHNSON
VICE PRESIDENT
407 S BROADWAY
LEROY MN 55951

Officer/Director/Trustee Three

JANET MAYER
SECRETARY
407 S BROADWAY
LEROY MN 55951

Officer/Director/Trustee Four

NORMAN HANSON
TREASUER
407 S BROADWAY
LEROY MN 55951

Officer/Director/Trustee Five

SHARON GRASS
DIRECTOR
407 S BROADWAY
LEROY MN 55951

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/2/2015
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A50 - Museum, Museum Activities
Organization’s purpose Charitable: No
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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