FORM 1023-EZ for CHAFFEE HISTORICAL MUSEUM

Field Data
EIN 86-3838279
Case Number EO-2021160-000291
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CHAFFEE HISTORICAL MUSEUM
Organization’s Mailing Address 109 SOUTH MAIN
City CHAFFEE
State MO
ZIP 63740
Accounting period End 12
Primary contact name RONALD EICHHORN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RONALD EICHHORN
PRESIDENT
901 WEST MARTHA
CHAFFEE MO 63740

Officer/Director/Trustee Two

RICHARD VANDEVEN
VICE PRESIDENT
328 COUNTY ROAD 220
CHAFFEE MO 63740

Officer/Director/Trustee Three

JANET LOUCKS
SECRETARY
324 GRAY
CHAFFEE MO 63740

Officer/Director/Trustee Four

TARA GOLIGHTLY
TREASURER
619 SOUTH THIRD
CHAFFEE MO 63740

Officer/Director/Trustee Five

JACQUELYN VANDEVEN
TRUSTEE
328 COUNTY ROAD 220
CHAFFEE MO 63740

Organization’s website NA
Organization’s email DAEDREAM53@HOTMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/13/2021
Organization Incorporation State MO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A54 - History Museums
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 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 RONALD EICHHORN
Signature Title PRESIDENT
Signature Date 6/7/2021

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