FORM 1023-EZ for HOWARD E & CAROLE E HARKINS CHARITABLE TRUST

Field Data
EIN 47-7109012
Case Number EO-2018280-000039
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HOWARD E & CAROLE E HARKINS CHARITABLE TRUST
Organization’s Mailing Address 4300 EAST 53RD STREET SUITE 103
City DAVENPORT
State IA
ZIP 52807
Accounting period End 12
Primary contact name DANIEL P ELLARD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MARK S FENSTERBUSCH
TRUSTEE
2640 RIVER BEND ROAD
BETTENDORF IA 52722

Organization’s website
Organization’s email
Organization Incorporated
Organization trust Yes
Necessary Organizing Documents Yes
Organization Incorporation Date 6/15/15
Organization Incorporation State IA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P82 - Developmentally Disabled Centers, Services
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
Scientific: Yes
Literary: Yes
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement Yes
Correctness Declaration Yes
Signature Name MARK S FENSTERBUSCH
Signature Title TRUSTEE
Signature Date 10/3/18
EIN 47-7109012
Case Number EO-2015176-000428
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HOWARD E CAROLE E HARKINS CHARITABLE TRUST
Organization’s Mailing Address 39 RIVERVIEW PARK DRIVE
City BETTENDORF
State IA
ZIP 52722
Accounting period End 12
Primary contact name DANIEL P ELLARD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

HOWARD HARKINS
TRUSTEE
39 RIVERVIEW PARK DRIVE
BETTENDORF IA 52722

Organization’s website
Organization’s email
Organization Incorporated
Organization trust Yes
Necessary Organizing Documents Yes
Organization Incorporation Date 6/15/2015
Organization Incorporation State IA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P82 - Developmentally Disabled Centers, Services
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
Scientific: Yes
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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