FORM 1023-EZ for HIGH SPRINGS HISTORICAL SOCIETY INC

Field Data
EIN 34-1975179
Case Number EO-2014256-000142
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HIGH SPRINGS HISTORICAL SOCIETY INC
Organization’s Mailing Address 120 NW 2ND AVENUE
City HIGH SPRINGS
State FL
ZIP 32643
Accounting period End 12
Primary contact name CAROLYN DYKSTERHOUSE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ROBERT WATSON
PRESIDENT
120 NW 2ND AVENUE
HIGH SPRINGS FL 32643

Officer/Director/Trustee Two

CAROLYN DYKSTERHOUSE
TREASURER
120 2ND AVENUE
HIGH SPRINGS FL 32643

Officer/Director/Trustee Three

JAMES DYKSTERHOUSE
VICE PRESIDENT
120 2ND AVENUE
HIGH SPRINGS FL 32643

Officer/Director/Trustee Four

PRISCILLA KARRAS
SECRETARY
120 NW 2ND AVENUE
HIGH SPRINGS FL 32643

Officer/Director/Trustee Five

SAMUEL VIVIANO
DIRECTOR
120 NW 2ND AVENUE
HIGH SPRINGS FL 32643

Organization’s website
Organization’s email HSMUSEUM@MSN.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/19/2014
Organization Incorporation State FL
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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