FORM 1023-EZ for JEFFERSON TOWNSHIP LAND CONSERVATION ASSOCIATION

Field Data
EIN 31-1604629
Case Number EO-2017230-000156
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name JEFFERSON TOWNSHIP LAND CONSERVATION ASSOCIATION
Organization’s Mailing Address 6545 HAVENS ROAD
City BLACKLICK
State OH
ZIP 43004
Accounting period End 12
Primary contact name JANE PFEIFER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

STEPHEN WITTMANN
TRUSTTE AND CHAIR
3383 MANN ROAD
BLACKLICK OH 43004

Officer/Director/Trustee Two

SALLY CRANE COX
TRUSTEE AND VICE CHAIR
2600 CROOKED MILE ROAD
BLACKLICK OH 43004

Officer/Director/Trustee Three

JOHN ALBERS
TRUSTEE AND TREASURER
3405 MANN ROAD
BLACKLICK OH 43004

Officer/Director/Trustee Four

LINDA MOSBACHER
TRUSTEE AND SECRETARY
6381 CLARK STATE RD
BLACKLICK OH 43004

Officer/Director/Trustee Five

MIKE ROWAN
TRUSTEE
6300 DARLING ST
BLACKLICK OH 43004

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/15/1998
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code C30 - Natural Resources Conservation and Protection
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement Yes
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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