FORM 1023-EZ for SIGOURNEY AFTER PROM

Field Data
EIN 42-1495847
Case Number EO-2015224-000279
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SIGOURNEY AFTER PROM
Organization’s Mailing Address 907 E PLEASANT VALLEY ST
City SIGOURNEY
State IA
ZIP 52591-1866
Accounting period End 5
Primary contact name HEATHER HAINES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

AMY KITZMANN ARDUSER
PRESIDENT
406 W PLEASANT VALLEY ST
SIGOURNEY IA 52591

Officer/Director/Trustee Two

ALISCA DE REGNIER
VICE PRESIDENT
302 ELM AVE
NORTH ENGLISH IA 52316

Officer/Director/Trustee Three

HEATHER HAINES
SECRETARY/TREASURER
18278 HWY 92
SIGOURNEY IA 52591

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/9/2014
Organization Incorporation State IA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B12 - Fund Raising and/or Fund Distribution
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
Signature Title
Signature Date

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