FORM 1023-EZ for DOROTHEA PAUL LEGACY ART FUND

Field Data
EIN 84-4889366
Case Number EO-2020317-000042
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name DOROTHEA PAUL LEGACY ART FUND
Organization’s Mailing Address 5933 WILD ROSE LN NW
City BEMIDJI
State MN
ZIP 56601-7257
Accounting period End 12
Primary contact name BERYL WERNBERG
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BERYL WERNBERG
PRESIDENT/TREASURER
5933 WILD ROSE LN NW
BEMIDJI MN 56601-7257

Officer/Director/Trustee Two

CHAR BLASHILL
SECRETARY
414 RAKO ST SW
BEMIDJI MN 56601-3498

Officer/Director/Trustee Three

DAVE REVIER
BOARD MEMBER
75382 350TH ST
OLIVIA MN 56277-2417

Officer/Director/Trustee Four

CHRIS REVIER
BOARD MEMBER
75382 350TH ST
OLIVIA MN 56277-2417

Officer/Director/Trustee Five

PARKER REVIER
BOARD MEMBER
75382 350TH ST
OLIVIA MN 56277-2417

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/26/2019
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B82 - Scholarships, Student Financial Aid Services, Awards
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 No
Disaster relief assistance No
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 BERYL WERNBERG
Signature Title PRESIDENT/TREASURER
Signature Date 11/10/2020

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