FORM 1023-EZ for BRUIN AREA VETERANS MEMORIAL ASSOCIATION

Field Data
EIN 83-3510970
Case Number EO-2019077-000761
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BRUIN AREA VETERANS MEMORIAL ASSOCIATION
Organization’s Mailing Address PO BOX V
City BRUIN
State PA
ZIP 16022-588
Accounting period End 12
Primary contact name AMY PETERS - PRESIDENT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

AMY PETERS
PRESIDENT
BOX 52
BRUIN PA 16022-52

Officer/Director/Trustee Two

KAREN CAMPBELL
TREASURER
BOX 333
BRUIN PA 16022-333

Officer/Director/Trustee Three

CHERYL MCCOLLOUGH
SECRETARY
264 BRUIN RD
PETROLIA PA 16050

Officer/Director/Trustee Four

ROBERTA FOX
VICE-PRESIDENT
BOX 277
BRUIN PA 16022-277

Officer/Director/Trustee Five

WALLACE EMERY
DIRECTOR
BOX 152
BRUIN PA 16022-152

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/22/19
Organization Incorporation State PA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S20 - Community, Neighborhood Development, Improvement (General)
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name AMY PETERS
Signature Title PRESIDENT
Signature Date 3/16/19

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