FORM 1023-EZ for PREHISTORICAL HISTORICAL SITE INC

Field Data
EIN 86-3646039
Case Number EO-2021145-000128
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PREHISTORICAL HISTORICAL SITE INC
Organization’s Mailing Address 768 MAIN STREET
City WARRENTON
State GA
ZIP 30828
Accounting period End 12
Primary contact name LURA GILLOM
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LURA GILLOM
CEO
1144 MAYFIELD ROAD
WARRENTON GA 30828-4415

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/17/2019
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A26 - Arts Council/Agency
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 Yes
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity Yes
Disaster relief assistance Yes
One Third Support Public No
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name LURA GILLOM
Signature Title CEO
Signature Date 5/24/2021

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