FORM 1023-EZ for BLACK HORSE TAVERN BROWNSVILLE

Field Data
EIN 87-2052552
Case Number EO-2021221-000651
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BLACK HORSE TAVERN BROWNSVILLE
Organization’s Mailing Address 203 FRONT STREET
City BROWNSVILLE
State PA
ZIP 15417
Accounting period End 12
Primary contact name BRIANNE MITCHELL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BRIANNE MITCHELL
PRESIDENT
560 PITTSBURGH RD
BROWNSVILLE PA 15417

Officer/Director/Trustee Two

HERBERT MITCHELL
VP
560 PITTSBURGH RD
BROWNSVILLE PA 15417

Officer/Director/Trustee Three

HERBERT MITCHELL
TRUSTEE
815 YORK ST
BROWNSVILLE PA 15417

Organization’s website WWW.BLACKHORSETAVERNBROWNSVILLE.ORG
Organization’s email BLACKHORSETAVERNBROWNSVILLE@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/1/2021
Organization Incorporation State PA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A80 - Historical Societies, Related Historical Activities
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 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 BRIANNE MITCHELL
Signature Title PRESIDENT
Signature Date 8/6/2021

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