FORM 1023-EZ for HAZARD FILM PROJECT

Field Data
EIN 84-5181868
Case Number EO-2020087-000086
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HAZARD FILM PROJECT
Organization’s Mailing Address 4901 S MAC ARTHUR LN APT 11
City SIOUX FALLS
State SD
ZIP 57108
Accounting period End 3
Primary contact name DANIEL BERGESON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DANIEL BERGESON
DIRECTOR
4901 S MAC ARTHUR LN APT 11
SIOUX FALLS SD 57108

Officer/Director/Trustee Two

BOBBY PEACOCK
DIRECTOR
1216 E KEYSTONE PL APT 59
BRANDON SD 57005

Officer/Director/Trustee Three

RODNEY BERGESON
DIRECTOR
4313 S TOWN PARK PL
SIOUX FALLS SD 57105

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/23/2020
Organization Incorporation State SD
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A20 - Arts, Cultural Organizations - Multipurpose
Organization’s purpose Charitable: Yes
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 Yes
Donation of funds Yes
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 DANIEL BERGESON
Signature Title DIRECTOR
Signature Date 3/25/2020

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