FORM 1023-EZ for MR LOCAL HISTORY INC

Field Data
EIN 84-3350277
Case Number EO-2019323-000282
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MR LOCAL HISTORY INC
Organization’s Mailing Address 184 W OAK STREET
City BASKING RIDGE
State NJ
ZIP 7920-1743
Accounting period End 12
Primary contact name BROOKS BETZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PAULA AXT
TREASURER
61 WINDING LANE
BASKING RIDGE NJ 7920-1743

Officer/Director/Trustee Two

JILL BETZ
VICE PRESIDENT
184 W OAK STREET
BASKING RIDGE NJ 7920-1743

Officer/Director/Trustee Three

MEG WASTIE
SECRETARY
57 VILLAGE DRIVE
BASKING RIDGE NJ 7920-1342

Officer/Director/Trustee Four

BROOKS BETZ
PRESIDENT
184 W OAK STREET
BASKING RIDGE NJ 7920-1743

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/26/19
Organization Incorporation State NJ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T31 - Community Foundations
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 No
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 Yes
Disaster relief assistance No
One Third Support Public No
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name BROOKS BETZ
Signature Title PRESIDENT
Signature Date 11/17/19

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