FORM 1023-EZ for THE PENNY HOUSE

Field Data
EIN 81-4927541
Case Number EO-2017040-000181
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name THE PENNY HOUSE
Organization’s Mailing Address 115 10TH ST W
City HARVEY
State ND
ZIP 58341-9362
Accounting period End 5
Primary contact name TYLER LARSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TYLER LARSON
PRESIDENT
2971 13TH ST NE
HARVEY ND 58341-9362

Officer/Director/Trustee Two

ANN ADAMS
DIRECTOR
325 CLARK AVE
HARVEY ND 58341

Officer/Director/Trustee Three

BRICE WAKEFIELD
SECRETARY
2774 17TH ST NE
HAREVY ND 58341-9346

Officer/Director/Trustee Four

KATHLEEN MUSCHA
DIRECTOR
3236 26TH ST NE
HARVEY ND 58341-8225

Organization’s website
Organization’s email HARVEYPENNYHOUSE@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/15/2016
Organization Incorporation State ND
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O20 - Youth Centers, Clubs, Multipurpose
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: Yes
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee Yes
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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