FORM 1023-EZ for HAUSER LIONS CLUB FOUNDATION

Field Data
EIN 84-3751193
Case Number EO-2019326-000435
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HAUSER LIONS CLUB FOUNDATION
Organization’s Mailing Address PO BOX 1664
City POST FALLS
State ID
ZIP 83877-1664
Accounting period End 6
Primary contact name WENDY WERNER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MICHAEL SHANE KAMPS
PRESIDENT
11525 N HAUSER LAKE ROAD
HAUSER ID 83854

Officer/Director/Trustee Two

LAURIE GRIFFITH
SECRETARY
1869 E SELTICE WAY STE 179
POST FALLS ID 83854

Officer/Director/Trustee Three

JAMES LEWIS
TREASURER
16400 W SALA LANE
HAUSER ID 83854

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/9/19
Organization Incorporation State ID
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name LAURIE GRIFFITH
Signature Title SECRETARY
Signature Date 11/20/19

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