FORM 1023-EZ for HUMBOLDT COUNTY HOMESCHOOL ASSOCIATION

Field Data
EIN 81-1951469
Case Number EO-2016127-000056
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HUMBOLDT COUNTY HOMESCHOOL ASSOCIATION
Organization’s Mailing Address 694 CASTLE WAY
City WINNEMUCCA
State NV
ZIP 89445
Accounting period End 12
Primary contact name REBECCA COLEMAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

REBECCA COLEMAN
PRESIDENT
694 CASTLE WAY
WINNEMUCCA NV 89445

Officer/Director/Trustee Two

SARAH SILVA
TREASURER
3705 SEGO ROAD
WINNEMUCCA NV 89445

Officer/Director/Trustee Three

LEIGH BARNARD
SECRETARY
5975 OLD JUNGO ROAD
WINNEMUCCA NV 89445

Officer/Director/Trustee Four

TIFFANY BENGOA
VICE-PRESIDENT
2852 FRONTIER STREET
WINNEMUCCA NV 89445

Organization’s website
Organization’s email HUMBOLDTCOUNTYHOMESCHOOLASSOC@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/13/2016
Organization Incorporation State NV
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B99 - Education N.E.C.
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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