FORM 1023-EZ for BROOKFIELD TOWNSHIP HISTORICAL SOCIETY

Field Data
EIN 47-5214903
Case Number EO-2015320-000391
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BROOKFIELD TOWNSHIP HISTORICAL SOCIETY
Organization’s Mailing Address 6844 STRIMBU DRIVE
City BROOKFIELD
State OH
ZIP 44403
Accounting period End 12
Primary contact name LOIS WERNER-VICE PRESIDENT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ELIZABETH BOOZER
PRESIDENT
BOX 44
BROOKFIELD OH 44403

Officer/Director/Trustee Two

SYLVIA ADDICOTT
TREASURER
765 KIMBERLY AVENUE NE
MASURY OH 44438

Officer/Director/Trustee Three

LOIS WERNER
VICE PRESIDENT CO-TREASURER
861 STATE ROUTE 7 NE
BROOKFIELD OH 44403

Officer/Director/Trustee Four

DAWN BURNS
SECRETARY
1187 SHARON HOGUE ROAD
MASURY OH 44438

Organization’s website BROOKFIELDOHIOHISTORY.ORG
Organization’s email MASURY@SBCGLOBAL.NET
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/12/2015
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A82 - Historical Preservation
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 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
Signature Title
Signature Date

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