FORM 1023-EZ for PLEASANT HILL MEMORIAL

Field Data
EIN 42-6099133
Case Number EO-2017069-000304
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PLEASANT HILL MEMORIAL
Organization’s Mailing Address 1794 REDWOOD AVENUE
City JEFFERSON
State IA
ZIP 50129
Accounting period End 12
Primary contact name WALLACE W TEAGARDEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

WALLACE W TEAGARDEN
PRESIDENT DIRECTOR
2214 BURNETT AVENUE
AMES IA 50010

Officer/Director/Trustee Two

DONALD D FRANK
DIRECTOR
407 NORTH 4TH AVENUE
WINTERSET IA 50273

Officer/Director/Trustee Three

NED JOHNSON
DIRECTOR
201 2ND STREET
RIPPEY IA 50235

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/8/1966
Organization Incorporation State IA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A50 - Museum, Museum Activities
Organization’s purpose Charitable: No
Religious: Yes
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 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 No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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