FORM 1023-EZ for GENOA HISTORICAL SOCIETY INC

Field Data
EIN 35-2664259
Case Number EO-2019238-000239
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name GENOA HISTORICAL SOCIETY INC
Organization’s Mailing Address PO BOX 121
City GENOA
State OH
ZIP 43430
Accounting period End 12
Primary contact name ELLEN E BERGMAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

THOMAS E BERGMAN
PRESIDENT
217 E 11TH STREET
GENOA OH 43430

Officer/Director/Trustee Two

AARON J PARKS
VICE PRESIDENT
210 E 10TH STREET
GENOA OH 43430

Officer/Director/Trustee Three

ELLEN E BERGMAN
SECRETARY/TREASURER
217 E 11TH STREET
GENOA OH 43430

Officer/Director/Trustee Four

GAYLORD SHELDON
COMMUNITY CONSULTANT
21232 E HOLTS EAST RD
GENOA OH 43430

Officer/Director/Trustee Five

JERRY HEBERT
MEDIA CORDINATOR
525 E INDIANA AVE
PERRYSBURG OH 43551

Organization’s website GENOAHISTORICALSOCIETY.COM
Organization’s email GENOAHISTORICALSOCIETY@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/15/19
Organization Incorporation State OH
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: 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 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 ELLEN E BERGMAN
Signature Title SECRETARY/TREASURER
Signature Date 8/22/19

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