FORM 1023-EZ for BETHANIA CEMETERY ASSOCIATION

Field Data
EIN 41-2006630
Case Number EO-2014338-000090
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BETHANIA CEMETERY ASSOCIATION
Organization’s Mailing Address 33683 180TH AVENUE NW
City NEWFOLDEN
State MN
ZIP 56738-9263
Accounting period End 12
Primary contact name SHARON BRING
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

RODNEY LIEDBERG
CHAIRMAN
33683 180TH AVENUE NW
NEWFOLDEN MN 56738-9263

Officer/Director/Trustee Two

DENNIS GRAY
VICE CHAIRMAN
19594 350TH STREET NW
NEWFOLDEN MN 56738-9286

Officer/Director/Trustee Three

GAIL BJORGAARD
SECRETARY
35248 170TH AVENUE NW
NEWFOLDEN MN 56738-9268

Officer/Director/Trustee Four

SHARON BRING
TREASURER
20897 360TH STREET NW
STRANDQUIST MN 56758-9729

Organization’s website
Organization’s email SBRING@WIKTEL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/25/2000
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Y50 - Cemeteries, Burial Services
Organization’s purpose Charitable: Yes
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 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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