FORM 1023-EZ for SUSQUEHANNOCK FLY FISHERS INC

Field Data
EIN 20-3915199
Case Number EO-2019217-000328
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SUSQUEHANNOCK FLY FISHERS INC
Organization’s Mailing Address 433 MEADOWVIEW DR
City LEBANON
State PA
ZIP 17042
Accounting period End 12
Primary contact name PHILLIP HEAGY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KEITH TEMPLIN
PRESIDENT
428 BRICKER LANE
LEBANON PA 17042

Officer/Director/Trustee Two

KRIS HEPLER
VICE PRESIDENT
710 CANAL RD
WOMELSDORF PA 19567

Officer/Director/Trustee Three

PARK HAVERSTICK
TREASURER
8 JULIADA DR
LEBANON PA 17042

Officer/Director/Trustee Four

PHIL HEAGY
SECRETARY
433 MEADOWVIEW DR
LEBANON PA 17042

Organization’s website WWW.SUSQFF.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/12/05
Organization Incorporation State PA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B28 - Specialized Education Institutions
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 PHIL HEAGY
Signature Title SECRETARY
Signature Date 8/1/19

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