FORM 1023-EZ for SENIOR COMMUNITY CENTER OF VELVA

Field Data
EIN 45-0349961
Case Number EO-2016197-000298
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SENIOR COMMUNITY CENTER OF VELVA
Organization’s Mailing Address 122 MAIN ST
City VELVA
State ND
ZIP 58790
Accounting period End 12
Primary contact name LOIS LARSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

NORMA RIST
PRESIDENT
304 4TH AVE W
VELVA ND 58790

Officer/Director/Trustee Two

NORMA OLSON
VICE PRESIDENT
6TH ST W
VELVA ND 58790

Officer/Director/Trustee Three

PAT JOHNSON
SECRETARY
PO BOX 21
VELVA ND 58790

Officer/Director/Trustee Four

LOIS LARSON
TREASURER
411 3RD ST W
VELVA ND 58790

Officer/Director/Trustee Five

BURDETTE KITTETLSON
BOARD MEMBER
507 W CENTRAL
VELVA ND 58790

Organization’s website
Organization’s email VELVASENIORS @SRT.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/29/1972
Organization Incorporation State ND
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P81 - Senior Centers, Services
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 Yes
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 Yes
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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