FORM 1023-EZ for LAKE HAVASU MINERAL LAPIDARY GROUP

Field Data
EIN 81-2478152
Case Number EO-2016125-000214
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LAKE HAVASU MINERAL LAPIDARY GROUP
Organization’s Mailing Address 2186 MCCULLOCH BLVD UNIT B
City LAKE HAVASU CITY
State AZ
ZIP 86403
Accounting period End 1
Primary contact name HANK SMEDLEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

HANK SMEDLEY
PRESIDENT
3263 CINNAMON DR
LAKE HAVASU CITY AZ 86406

Officer/Director/Trustee Two

JERRY HARLEY
TREASURER
3431 ANTELOPE DR
LAKE HAVASU CITY AZ 86404

Officer/Director/Trustee Three

LINDA HARLEY
VICE PRESIDENT
3431 ANTELOPE DR
LAKE HAVASU CITY AZ 86404

Officer/Director/Trustee Four

KATHIE BRYSON
SECRETARY
3373 BLUEGRASS DR
LAKE HAVASU CITY AZ 86406

Officer/Director/Trustee Five

ED DARNELL
SERGEANT AT ARMS
1534 BEACHCOMBER DR
LAKE HAVASU CITY AZ 86403

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/11/2016
Organization Incorporation State AZ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code U36 - Geology
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
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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