FORM 1023-EZ for PROVERBS 12-10

Field Data
EIN 84-3684884
Case Number EO-2019322-000320
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PROVERBS 12-10
Organization’s Mailing Address 12972 MADISON RD
City HUNTSBURG
State OH
ZIP 44046
Accounting period End 12
Primary contact name LISA ASH ARMFELT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LISA ARMFELT
PRESIDENT
12972 MADISON RD
HUNTSBURG OH 44046

Officer/Director/Trustee Two

ZACHARY ARMFELT
VICE PRESIDENT
12972 MADISON RD
HUNTSBURG OH 44046

Officer/Director/Trustee Three

BEVERLY ASH
SECRETARY/TREASURER
12972 MADISON RD
HUNTSBURG OH 44046

Officer/Director/Trustee Four

LLOYD KOEBEL
VICE PRESIDENT
12972 MADISON RD
HUNTSBURG OH 44046

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/1/19
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D20 - Animal Protection and Welfare
Organization’s purpose Charitable: No
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: Yes
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 LISA ARMFELT
Signature Title PRESIDENT
Signature Date 11/14/19

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