FORM 1023-EZ for PEYTON HAYES FOUNDATION INCORPORATED

Field Data
EIN 83-3732795
Case Number EO-2019059-000440
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PEYTON HAYES FOUNDATION INCORPORATED
Organization’s Mailing Address 1338 MOON FLOWER AVE
City TIFFIN
State IA
ZIP 52340
Accounting period End 12
Primary contact name DARRIN HAYES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DARRIN HAYES
PRESIDENT
1338 MOON FLOWER AVE
TIFFIN IA 52301

Officer/Director/Trustee Two

MATT FULTS
BOARD MEMBER
899 CHERRY AVE
MARENGO IA 52301

Officer/Director/Trustee Three

JENNIFER HAYES
VICE PRESIDENT
1338 MOON FLOWER AVE
TIFFIN IA 52340

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/11/19
Organization Incorporation State IA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E86 - Patient Services - Entertainment, Recreation
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 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 DARRIN HAYES
Signature Title PRESIDENT
Signature Date 2/26/19

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