FORM 1023-EZ for KEYSTONE CHAPEL VILLAGE

Field Data
EIN 81-1278840
Case Number EO-2016088-000666
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name KEYSTONE CHAPEL VILLAGE
Organization’s Mailing Address 17402 N KENNAN CT
City HAYDEN
State ID
ZIP 83835-8999
Accounting period End 12
Primary contact name ARNELL HAWS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

BRITTNY HAWS
TREASURER
17402 N KENNAN CT
HAYDEN ID 83835-8999

Officer/Director/Trustee Two

ARNELL HAWS
SECRETARY
17402 N KENNAN CT
HAYDEN ID 83835-8999

Officer/Director/Trustee Three

VINCENT HAWS
VICE CHAIR
17402 N KENNAN CT
HAYDEN ID 83835-8999

Officer/Director/Trustee Four

JOSEPH ARVESON
CHAIR
17402 N KENNAN CT
HAYDEN ID 83835-8999

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/11/2016
Organization Incorporation State ID
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code L40 - Low-Cost Temporary Housing
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 No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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