FORM 1023-EZ for CITY OF PALM COAST HISTORICAL SOCIETY AND MUSEUM INC

Field Data
EIN 30-0963534
Case Number EO-2017019-000425
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CITY OF PALM COAST HISTORICAL SOCIETY AND MUSEUM INC
Organization’s Mailing Address PO BOX 352613
City PALM COAST
State FL
ZIP 32135
Accounting period End 12
Primary contact name CAROL K LEMIEUX
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

WILLIAM VENNE
PRESIDENT
27 BECKER LANE
PALM COAST FL 32137

Officer/Director/Trustee Two

PETER KROEGER
VICE PRESIDENT
29 LAGO VISTA PLACE
PALM COAST FL 32164

Officer/Director/Trustee Three

CAROL LEMIEUX
TREASURER
70 RIVERS EDGE LANE
PALM COAST FL 32137

Officer/Director/Trustee Four

JACK PITMAN
DIRECTOR
12 WENDY LANE
PALM COAST FL 32164

Officer/Director/Trustee Five

PATRICIA ELDRIDGE
RECORDING SECRETARY
86 LAKE FOREST PLACE
PALM COAST FL 32137

Organization’s website PALMCOASTHISTORY.ORG
Organization’s email PALMCOASTHISTORICAL@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/15/2016
Organization Incorporation State FL
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: No
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 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
Signature Title
Signature Date

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