FORM 1023-EZ for PENDLETON HISTORICAL SOCIETY

Field Data
EIN 22-2506165
Case Number EO-2017010-000243
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PENDLETON HISTORICAL SOCIETY
Organization’s Mailing Address 6570 CAMPBELL BLVD
City LOCKPORT
State NY
ZIP 14094
Accounting period End 12
Primary contact name CAROL MOELLER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CAROL MOELLER
PRESIDENT
4915 BEACH RIDGE RD
LOCKPORT NY 14094

Officer/Director/Trustee Two

JEAN HAYLETT
TREASURER
4706 N TONAWANDA CREEK RD
N TONAWANDA NY 14120

Officer/Director/Trustee Three

NONA GOODRICH
BOARD MEMBER
6927 BEAR RIDGE RD
N TONAWANDA NY 14120

Officer/Director/Trustee Four

MELODY ZUERCH
BOARD MEMBER
6633 HEATHER DR
LOCKPORT NY 14094

Officer/Director/Trustee Five

JANET KARNES
VICE PRESIDENT
6961 E CANAL RD
LOCKPORT NY 14094

Organization’s website NA
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/1/1984
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A80 - Historical Societies, Related Historical Activities
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 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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