FORM 1023-EZ for BROWNSVILLE WESTERN HERITAGE INC

Field Data
EIN 82-4602169
Case Number EO-2018061-000196
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BROWNSVILLE WESTERN HERITAGE INC
Organization’s Mailing Address 49831 N HWY 188
City PAYSON
State AZ
ZIP 85541
Accounting period End 12
Primary contact name LORI L BROWN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LORI BROWN
DIRECTOR
49831 N HWY 188
PAYSON AZ 85541

Officer/Director/Trustee Two

BILL BROWN
DIRECTOR
49831 N HWY 188
PAYSON AZ 85541

Officer/Director/Trustee Three

CHARLENE HUNT BROWN
DIRECTOR
4997 N COLTER WAY
STRAWBERRY AZ 85544

Officer/Director/Trustee Four

JESSICA BARNETT
DIRECTOR
106 N OVERLAND CIRCLE
PAYSON AZ 85541

Organization’s website
Organization’s email BLACKMOUNTAINEXCAVATINGINC@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/16/18
Organization Incorporation State AZ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N69 - Equestrian, Riding
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 Yes
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 LORI BROWN
Signature Title DIRECTOR
Signature Date 2/28/18

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