FORM 1023-EZ for EAGLE FIRE LOCAL 4553 BURNOUT FUNDINCORPORATED

Field Data
EIN 38-3748221
Case Number EO-2019037-000650
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name EAGLE FIRE LOCAL 4553 BURNOUT FUNDINCORPORATED
Organization’s Mailing Address PO BOX 971
City EAGLE
State ID
ZIP 83616
Accounting period End 12
Primary contact name KELSEY BACKEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KELSEY BACKEN
SECRETARY/TREASURER
1457 E FEATHER NEST CT
EAGLE ID 83616

Officer/Director/Trustee Two

THERON HUDSON
VICE-PRESIDENT
205 E BEACON LIGHT RD
EAGLE ID 83616

Officer/Director/Trustee Three

JOSHUA BRADSHAW
PRESIDENT
264 W RUSH CT
EAGLE ID 83616

Officer/Director/Trustee Four

BENJAMIN MORS
TREASURER
1235 N FORESTDALE PL
EAGLE ID 83616

Officer/Director/Trustee Five

TAVIS SORENSEN
TREASURER
2914 EDSON ST
BOISE ID 83705

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/4/09
Organization Incorporation State ID
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W99 - Public, Society Benefit - Multipurpose and Other N.E.C.
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 Yes
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 Yes
Correctness Declaration Yes
Signature Name KELSEY BACKEN
Signature Title SECRETARY/TREASURER
Signature Date 1/28/19
EIN 38-3748221
Case Number EO-2019037-000650
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name EAGLE FIRE LOCAL 4553 BURNOUT FUND INCORPORATED
Organization’s Mailing Address PO BOX 971
City EAGLE
State ID
ZIP 83616
Accounting period End 12
Primary contact name KELSEY BACKEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KELSEY BACKEN
SECRETARY/TREASURER
1457 E FEATHER NEST CT
EAGLE ID 83616

Officer/Director/Trustee Two

THERON HUDSON
VICE-PRESIDENT
205 E BEACON LIGHT RD
EAGLE ID 83616

Officer/Director/Trustee Three

JOSHUA BRADSHAW
PRESIDENT
264 W RUSH CT
EAGLE ID 83616

Officer/Director/Trustee Four

BENJAMIN MORS
TREASURER
1235 N FORESTDALE PL
EAGLE ID 83616

Officer/Director/Trustee Five

TAVIS SORENSEN
TREASURER
2914 EDSON ST
BOISE ID 83705

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/4/09
Organization Incorporation State ID
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W99 - Public, Society Benefit - Multipurpose and Other N.E.C.
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 Yes
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 Yes
Correctness Declaration Yes
Signature Name KELSEY BACKEN
Signature Title SECRETARY/TREASURER
Signature Date 1/28/19

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