FORM 1023-EZ for YOUR ART HERE

Field Data
EIN 84-2342910
Case Number EO-2019193-000154
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name YOUR ART HERE
Organization’s Mailing Address 1919 KOSOLA AVE
City FAIRFIELD
State IA
ZIP 52556
Accounting period End 12
Primary contact name ROBERT JOHNSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ROBERT JOHNSON
DIRECTOR
1919 KOSOLA AVE
FAIRFIELD IA 52556

Officer/Director/Trustee Two

PAUL MOREHEAD
DIRECTOR
707 SOUTH MAIN ST
FAIRFIELD IA 52556

Officer/Director/Trustee Three

MAKENZIE CHAMP
DIRECTOR
PO BOX 1665
FAIRFIELD IA 52556

Officer/Director/Trustee Four

AARON HIRSHBERG
DIRECTOR
116 W BURLINGTON AVE
FAIRFIELD IA 52556

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/9/19
Organization Incorporation State IA
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 ROBERT JOHNSON
Signature Title DIRECTOR
Signature Date 7/10/19

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