FORM 1023-EZ for THE OLDEST HOUSE-LACEYVILLE AREA HISTORICAL SOCIETY

Field Data
EIN 90-0609410
Case Number EO-2015002-000180
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name THE OLDEST HOUSE-LACEYVILLE AREA HISTORICAL SOCIETY
Organization’s Mailing Address 297 MAIN STREET PO BOX 175
City LACEYVILLE
State PA
ZIP 18623-7873
Accounting period End 12
Primary contact name DEBORAH STEVENS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ANTHONY DEREMER
PRESIDENT
270 SINGER RD
LACEYVILLE PA 18623-7873

Officer/Director/Trustee Two

DEBORAH STEVENS
VICE-PRESIDENT
251 CORNELL RD
LACEYVILLE PA 18623-7873

Officer/Director/Trustee Three

SHIRLEY BULLOCK
TREASURER
2520 SR 4002
MEHOOPANY PA 18629-7790

Officer/Director/Trustee Four

DEBORAH COURVILLE
SECRETARY
637 DOOLITTLE HILL
LACEYVILLE PA 18623-7873

Officer/Director/Trustee Five

JUDY MEAD
BOARD MEMBER
1 COURTHOUSE SQUARE
TUNKHANNOCK PA 18657-7825

Organization’s website NONE
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/4/1976
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: 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 Yes
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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