FORM 1023-EZ for POLK COUNTY ARTIST ASSOCIATION

Field Data
EIN 30-0951016
Case Number EO-2017058-000603
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name POLK COUNTY ARTIST ASSOCIATION
Organization’s Mailing Address 120 S SPRINGFIELD AVE
City BOLIVAR
State MO
ZIP 65613
Accounting period End 12
Primary contact name VICKI WINGATE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CONNIE HENDERSON
PRESIDENT
2114 S HEDGEWOOD
BOLIVAR MO 65613

Officer/Director/Trustee Two

CAROL KLARR
BOARD MEMBER
745 E 395TH ROAD
DUNNEGAN MO 65640

Officer/Director/Trustee Three

VICKI WINGATE
TREASURER
1360 MEADOW LANE
BOLIVAR MO 65613

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/14/2016
Organization Incorporation State MO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A20 - Arts, Cultural Organizations - Multipurpose
Organization’s purpose Charitable: No
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 Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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