FORM 1023-EZ for HOUTZDALE REVITALIZATION ASSOCIATION

Field Data
EIN 84-4890684
Case Number EO-2020317-000249
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HOUTZDALE REVITALIZATION ASSOCIATION
Organization’s Mailing Address PO BOX 144
City HOUTZDALE
State PA
ZIP 16651
Accounting period End 12
Primary contact name ELSIE HARCHAK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOSHUA BERNDT
PRESIDENT
1405 W HANNAH ST
HOUTZDALE PA 16651-1927

Officer/Director/Trustee Two

TONIA SAUPP-BURLEY
VICE PRESIDENT
625 WEST 16TH STREET
TYRONE PA 16686-2164

Officer/Director/Trustee Three

ANN BERENBROK
TREASURER
603 SUE STREET
HOUTZDALE PA 16651-1035

Officer/Director/Trustee Four

ELSIE HARCHAK
TREASURER
5570 MORANN AVENUE
HOUTZDALE PA 16651-1540

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/24/2020
Organization Incorporation State PA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S20 - Community, Neighborhood Development, Improvement (General)
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
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 Yes
Disaster relief assistance Yes
One Third Support Public Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name JOSHUA BERNDT
Signature Title PRESIDENT
Signature Date 11/9/2020

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