FORM 1023-EZ for GOLDEN VALLEY LUTHERAN CHURCH PRESERVATION FOUNDATION

Field Data
EIN 20-0755705
Case Number EO-2017275-000628
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name GOLDEN VALLEY LUTHERAN CHURCH PRESERVATION FOUNDATION
Organization’s Mailing Address 24054 PALMER GULCH RD
City HILL CITY
State SD
ZIP 57745
Accounting period End 12
Primary contact name KATHRYN JOHNSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KATHRYN JOHNSON
PRESIDENT
24054 PALMER GULCH RD
HILL CITY SD 57745

Officer/Director/Trustee Two

SANDRA BRENTLINGER
SECRETARY
7846 DIAGONAL RD SE
OLYMPIA WA 98501

Officer/Director/Trustee Three

AVIS HOWE
TREASURER
10043 BORDERLINE RD
HETTINGER ND 58639

Officer/Director/Trustee Four

GAYLE DURGIN
VICE-PRESIDENT
12768 BLACK FOREST RD
RAPID CITY SD 57702

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/30/2005
Organization Incorporation State SD
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: 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 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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