FORM 1023-EZ for PLEASANT HILL LIONS FOUNDATION

Field Data
EIN 82-3685238
Case Number EO-2018087-000130
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PLEASANT HILL LIONS FOUNDATION
Organization’s Mailing Address PO BOX 57432
City PLEASANT HILL
State IA
ZIP 50327
Accounting period End 6
Primary contact name JULIE PELLEGRINO
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CURT GAUSE
PRESIDENT
400 TYLER DRIVE
PLEASANT HILL IA 50327

Officer/Director/Trustee Two

JULIE PELLEGRINO
SECRETARY
5510 SUNRISE DRIVE
PLEASANT HILL IA 50327

Officer/Director/Trustee Three

SCOTT NICHOLS
TREASURER
5324 SUSAN CT
PLEASANT HILL IA 50327

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/8/17
Organization Incorporation State IA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S80 - Community Service Clubs
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 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 JULIE PELLEGRINO
Signature Title SECRETARY
Signature Date 3/26/18

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