FORM 1023-EZ for MILLERS HOUSE MUSEUM FOUNDATION

Field Data
EIN 47-2123689
Case Number EO-2014297-000109
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MILLERS HOUSE MUSEUM FOUNDATION
Organization’s Mailing Address 7 WALLACE STREET
City LEXINGTON
State VA
ZIP 24450-2240
Accounting period End 12
Primary contact name RICHARD HALSETH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

RICHARD HALSETH
PRESIDENT
7 WALLACE STREET
LEXINGTON VA 24450-2240

Officer/Director/Trustee Two

STEVE BECK
VICE PRESIDENT
96 GINGERBREAD LANE
GLASGOW VA 24555-2177

Officer/Director/Trustee Three

JEAN CLARK
SECRETARY
2159 SPRING VALLEY ROAD
LEXINGTON VA 24450-7257

Officer/Director/Trustee Four

JON ELLESTAD
TREASURER
412 CONFEDERATE CIRCLE
LEXINGTON VA 24450-1716

Officer/Director/Trustee Five

BEVERLY TUCKER
DIRECTOR
872 ENFIELD ROAD
LEXINGTON VA 24450-4047

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/15/2014
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A54 - History Museums
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 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 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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