FORM 1023-EZ for FAIRLINGTON HISTORICL SOCIETY

Field Data
EIN 54-1998162
Case Number EO-2016291-000298
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name FAIRLINGTON HISTORICL SOCIETY
Organization’s Mailing Address 2776 SO ARLINGTON MILL DR NO 150
City ARLINGTON
State VA
ZIP 22206-3402
Accounting period End 12
Primary contact name PATRICIA CLARK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TERRY PLACEK
PRESIDENT
4819-A2 SO 30TH ST
ARLINGTON VA 22206

Officer/Director/Trustee Two

CYNTHIA KUNZ
VICE PRESIDENT
4639 SO 30TH ROAD
ARLINGTON VA 22206

Officer/Director/Trustee Three

PATRICIA CLARK
SECRETARY
4875-B SO 28TH ST
ARLINGTON VA 22206-1365

Organization’s website FARILINGTONHISTORICALSOCIETY.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/12/2000
Organization Incorporation State VA
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: 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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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