FORM 1023-EZ for SAMANTHA HARBER FUND

Field Data
EIN 30-0836813
Case Number EO-2014311-000336
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SAMANTHA HARBER FUND
Organization’s Mailing Address 7296 LAMBERT AVE NE
City ALBERTVILLE
State MN
ZIP 55301-4544
Accounting period End 12
Primary contact name STEPHANIE BISHOP
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

STEPHANIE BISHOP
PRESIDENT
7296 LAMBERT AVE NE
ALBERTVILLE MN 55301-4544

Officer/Director/Trustee Two

ANTHONY JOHNSON
DIRECTOR
7296 LAMBERT AVE NE
ALBERTVILLE MN 55301-4544

Officer/Director/Trustee Four

JULIE HARBER
DIRECTOR
23675 135TH AVE N
ROGERS MN 55374-8675

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/30/2014
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T70 - Fund Raising Organizations That Cross Categories
Organization’s purpose Charitable: Yes
Religious: No
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 Yes
One Third Support Gifts No
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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