FORM 1023-EZ for KNIGHTS ANTIQUITY HISTORICAL SOCIETY INC

Field Data
EIN 83-1631070
Case Number EO-2018234-000278
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name KNIGHTS ANTIQUITY HISTORICAL SOCIETY INC
Organization’s Mailing Address 9617 N CAMPBELL DR
City KANSAS CITY
State MO
ZIP 64155
Accounting period End 12
Primary contact name THOMAS W KOELLING
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

THOMAS KOELLING
DIRECTOR PRESIDENT
9617 N CAMPBELL DR
KANSAS CITY MO 64155

Officer/Director/Trustee Two

DWANE BOUCHER
DIRECTOR
1947 WESTVIEW ROAD
FALLBROOK CA 92028

Officer/Director/Trustee Three

KURTIS ORCUTT
DIRECTOR
4853 SOUTH NEWPORT STREET
CHANDLER AZ 85249

Officer/Director/Trustee Four

MATHEW KOELLING
VICE PRESIDENT
8544 N AVA AVENUE
KANSAS CITY MO 64154

Officer/Director/Trustee Five

BRAD CURTIS
TREASURER
875 CALLE VALLARTA
SAN CLEMENTE CA 92673

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/20/18
Organization Incorporation State MO
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: Yes
Literary: Yes
Public Safety: No
Amateur Sports: No
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee Yes
Donation of funds No
Conducting Activities Outside of United States Yes
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 THOMAS KOELLING
Signature Title DIRECTOR PRESIDENT
Signature Date 8/20/18

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