FORM 1023-EZ for MILLER HISTORICAL SOCIETY INC

Field Data
EIN 81-4645404
Case Number EO-2017003-000211
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MILLER HISTORICAL SOCIETY INC
Organization’s Mailing Address 264 N LAKE STREET
City GARY
State IN
ZIP 46403-1963
Accounting period End 12
Primary contact name CULLEN BEN DANIEL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CULLEN DANIEL
PRESIDENT
264 N LAKE STREET
GARY IN 46403-1963

Officer/Director/Trustee Two

DAVID ARFA
TREASURER
1445 W GREENLEAF AVE APT 3N
CHICAGO IL 60626-2821

Officer/Director/Trustee Three

WILLIAM ROTH
SECRETARY
1505 E 38TH PLACE
HOBART IN 46342-2437

Organization’s website MILLERHISTORY.ORG
Organization’s email MILLERHISTORICALSOCIETY@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/16/2013
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A80 - Historical Societies, Related Historical Activities
Organization’s purpose Charitable: Yes
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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