FORM 1023-EZ for PINE FORGE HISTORICAL SOCIETY

Field Data
EIN 71-0941348
Case Number EO-2016190-000088
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PINE FORGE HISTORICAL SOCIETY
Organization’s Mailing Address PO BOX 303 PINE FORGE ROAD
City PINE FORGE
State PA
ZIP 19548
Accounting period End 12
Primary contact name PHYLLIS MITCHELL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PHYLLIS MITCHELL
PRESIDENT
212 E BUCHERT RD
GILBERTSVILLE PA 19525

Officer/Director/Trustee Two

MICHAEL JONES
VICE-PRESIDENT
PO BOX 285
PINE FORGE PA 19548

Officer/Director/Trustee Three

DAVID RUTTER
TREASURER
3609 BELLWOOD DRIVE
NASHVILLE TN 37205

Officer/Director/Trustee Four

KIRK MITCHELL
SECRETARY
160 WESTBURY DRIVE
GIBERTSVILLE PA 19525-9458

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/9/2003
Organization Incorporation State PA
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: 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 Yes
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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