FORM 1023-EZ for HARLEM COMMUNITY PLAYGROUND

Field Data
EIN 83-3661399
Case Number EO-2019084-000511
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HARLEM COMMUNITY PLAYGROUND
Organization’s Mailing Address 16062 CENTER VILLAGE ROAD
City JOHNSTOWN
State OH
ZIP 43031
Accounting period End 12
Primary contact name HAROLD CHARLES BACHMAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

HAROLD CHARLES BACHMAN
PRESIDENT
16062 CENTER VILLAGE ROAD
JOHNSTOWN OH 43031

Officer/Director/Trustee Two

KAREN BACHMAN
SECRETARY
16062 CENTER VILLAGE ROAD
JOHNSTOWN OH 43031

Officer/Director/Trustee Three

LINDA SKINNER
TREASURER
14455 WOODTOWN ROAD
SUNBURY OH 43074

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/1/19
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N32 - Parks and Playgrounds
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 HAROLD CHARLES BACHMAN
Signature Title PRESIDENT
Signature Date 3/22/19

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