FORM 1023-EZ for A ONE ROOM SCHOOLHOUSE A HYBRID HOMESCHOOL ACADEMY

Field Data
EIN 83-3468898
Case Number EO-2019238-000740
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name A ONE ROOM SCHOOLHOUSE A HYBRID HOMESCHOOL ACADEMY
Organization’s Mailing Address 1005 LAKESIDE DR
City MCDONALD
State PA
ZIP 15057
Accounting period End 6
Primary contact name GENEVIEVE PETERSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

GENEVIEVE PETERSON
PRESIDENT
1005 LAKESIDE DR
MCDONALD PA 15057

Officer/Director/Trustee Two

PHILLIP PETERSON
VICE-PRESIDENT
1005 LAKESIDE DR
MCDONALD PA 15057

Officer/Director/Trustee Three

BRYAN DUFORD
TREASURER
112 N JAMESTOWN RD
MOON TWP PA 15108

Officer/Director/Trustee Four

STEPHANIE DUFORD
SECRETARY
112 N JAMESTOWN RD
MOON TWP PA 15108

Organization’s website WWW.AONEROOMSCHOOLHOUSE.COM
Organization’s email INFO@AONEROOMSCHOOLHOUSE.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/9/19
Organization Incorporation State PA
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 BRYAN DUFORD
Signature Title TREASURER
Signature Date 8/24/19

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