FORM 1023-EZ for PORT ORANGE HISTORICAL TRUST

Field Data
EIN 59-3747097
Case Number EO-2017201-000157
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PORT ORANGE HISTORICAL TRUST
Organization’s Mailing Address P O BOX 291156
City PORT ORANGE
State FL
ZIP 32129
Accounting period End 9
Primary contact name MARK PIERSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MARK PIERSON
PRESIDENT
1428 DEXTER DRIVE NORTH
PORT ORANGE FL 32129

Officer/Director/Trustee Two

ROBYN WELCH
VICE PRESIDENT
120 QUIET CIRCLE
PORT ORANGE FL 32128

Officer/Director/Trustee Three

CAROL KUBACKI
TREASURER
946 CRYSTAL LAKE DRIVE
PORT ORANGE FL 32127

Officer/Director/Trustee Four

GLENDA COURSEN
SECRETARY
181 WESTWOOD ROAD
DAYTONA BEACH FL 32119

Organization’s website
Organization’s email
Organization Incorporated
Organization trust Yes
Necessary Organizing Documents Yes
Organization Incorporation Date 12/24/1992
Organization Incorporation State FL
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 No
Disaster relief assistance No
One Third Support Public No
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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