FORM 1023-EZ for BUFFALO MUSEUM ONE ROOM SCHOOLHOUSE

Field Data
EIN 47-4515511
Case Number EO-2015197-000316
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BUFFALO MUSEUM ONE ROOM SCHOOLHOUSE
Organization’s Mailing Address 106 US 85
City BUFFALO
State SD
ZIP 57720
Accounting period End 12
Primary contact name DUSTY GINSBACH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

RAYFORD ANDERSON
PRESIDENT
310 3RD STREET WEST
BUFFALO SD 57720

Officer/Director/Trustee Two

KATHY GLINES
SECRETARY-TREASURER
104 LIONS STREET
BUFFALO SD 57720

Officer/Director/Trustee Three

WANDA LYONS
DIRECTOR
908 1ST STREET EAST
BUFFALO SD 57720

Officer/Director/Trustee Four

DENNIS BRENGLE
DIRECTOR
12338 OLD HIGHWAY 85
BUFFALO SD 57720

Officer/Director/Trustee Five

JOCLYN MOLLMAN
DIRECTOR
13685 LINCOLN RD
LUDLOW SD 57755

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/1/2015
Organization Incorporation State SD
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 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
Signature Title
Signature Date

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