FORM 1023-EZ for OLD HOME TOWN MUSEUM INC

Field Data
EIN 45-3744738
Case Number EO-2014276-000260
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name OLD HOME TOWN MUSEUM INC
Organization’s Mailing Address PO BOX 433
City STEPHEN
State MN
ZIP 56757-0433
Accounting period End 12
Primary contact name CINDY KUZNIA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JAN ANDERSON
PRESIDENT
717 POTATO PATCH RD/ PO BOX 593
STEPHEN MN 56757-0593

Officer/Director/Trustee Two

CINDY KUZNIA
VICE PRESIDENT
222 1ST ST/PO BOX 433
STEPHEN MN 56757-0433

Officer/Director/Trustee Three

PATSY HEGGEN
SECRETARY
565 DEWEY ST/PO BOX 181
STEPHEN MN 56757-0181

Officer/Director/Trustee Four

NONA CARL
TREASURER
311 ANGUS AVE/PO BOX 24
STEPHEN MN 56757-0024

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/1/2011
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A54 - History Museums
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
Signature Title
Signature Date

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