FORM 1023-EZ for LAKE HIDDENWOOD FOUNDATION INC

Field Data
EIN 84-3572743
Case Number EO-2019346-000181
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LAKE HIDDENWOOD FOUNDATION INC
Organization’s Mailing Address 6801 LINCOLN AVE PO BOX 131
City SELBY
State SD
ZIP 57472
Accounting period End 12
Primary contact name JEFFREY J STULKEN CPA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DESERAE SIMONS
TREASURER
6801 LINCOLN AVE PO BOX 131
SELBY SD 57472

Officer/Director/Trustee Two

SCOTT SCHILLING
PRESIDENT
507 SOUTH RAILWAY STREET PO BOX 118
SELBY SD 57472

Officer/Director/Trustee Three

DEBORAH BERENS
DIRECTOR
3016 6TH AVE PO BOX 175
SELBY SD 57472

Officer/Director/Trustee Four

LEAH HOLDER
SECRETARY
4200 5TH AVE PO BOX 12
SELBY SD 57472

Officer/Director/Trustee Five

BERNARD STULKEN
VICE PRESIDENT
12565 304TH AVE
SELBY SD 57472

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/11/2019
Organization Incorporation State SD
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 BERNARD STULKEN
Signature Title VICE PRESIDENT
Signature Date 12/10/2019

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