FORM 1023-EZ for WAVERLY COMMUNITY LIBRARY ASSOCIATION

Field Data
EIN 46-0881242
Case Number EO-2015254-000298
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name WAVERLY COMMUNITY LIBRARY ASSOCIATION
Organization’s Mailing Address PO BOX 7
City WAVERLY
State NE
ZIP 68462
Accounting period End 12
Primary contact name BRUCE SEDIVY--OFFICER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

BRUCE SEDIVY
PRESIDENT
10611 N 138TH STREET
WAVERLY NE 68462

Officer/Director/Trustee Two

KRIS BOHAC
V.PRESIDENT
10231 N 143RD STREET
WAVERLY NE 68462

Officer/Director/Trustee Three

MURLEEN BELLINGER
TREASURER
14330 DANVERS
WAVERLY NE 68462

Officer/Director/Trustee Four

SHIRLEY RINE
DIRECTOR
14431 DANVERS
WAVERLY NE 68462

Officer/Director/Trustee Five

JOANN DEXTER
DIRECTOR
14630 EASTBORNE
WAVERLY NE 68462

Organization’s website NA
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/24/2012
Organization Incorporation State NE
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B70 - Libraries
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
Scientific: No
Literary: Yes
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 Yes
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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