FORM 1023-EZ for PEPIN HILL AMATEUR RADIO AND TELEVISION SOCIETY INC

Field Data
EIN 83-2746056
Case Number EO-2018344-000344
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PEPIN HILL AMATEUR RADIO AND TELEVISION SOCIETY INC
Organization’s Mailing Address 21699 COUNTY ROAD 77
City WABASHA
State MN
ZIP 55981-266
Accounting period End 12
Primary contact name JONATHAN PETERSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JONATHAN PETERSON
PRESIDENT
21699 COUNTY ROAD 77
WABASHA MN 55981-266

Officer/Director/Trustee Two

ANN MCKENZIE
VICE-PRESIDENT
21699 COUNTY ROAD 77
WABASHA MN 55981-266

Officer/Director/Trustee Three

JULIE PETERSON
TREASURER
7950 HILLSIDE TRAIL SOUTH
COTTAGE GROVE MN 55016-3166

Officer/Director/Trustee Four

DARLA BADZINSKI
SECRETARY
65348 186TH AVENUE
WABASHA MN 55981-7578

Organization’s website
Organization’s email JONMCPETE@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/7/17
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code M99 - Public Safety, Disaster Preparedness, and Relief N.E.C.
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
Literary: No
Public Safety: Yes
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 No
Disaster relief assistance Yes
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 JONATHAN PETERSON
Signature Title PRESIDENT
Signature Date 12/6/18

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