FORM 1023-EZ for MERTENS VOLUNTEER FIRE DEPARTMENT

Field Data
EIN 80-0821150
Case Number EO-2014276-000370
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MERTENS VOLUNTEER FIRE DEPARTMENT
Organization’s Mailing Address P O BOX 75
City MERTENS
State TX
ZIP 76666
Accounting period End 9
Primary contact name FLOYD GREEN JR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JR SUROVIK
PRESIDENT, DIRECTOR
PO BOX 155
MERTENS TX 76666

Officer/Director/Trustee Two

CHAD DEGENER
SECRETARY, DIRECTOR
309 HCR 3422
MALONE TX 76660

Officer/Director/Trustee Three

DAVID KADDATZ
TREASURER, DIRECTOR
PO BOX 40
MERTENS TX 76666

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/23/2005
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code M99 - Public Safety, Disaster Preparedness, and Relief N.E.C.
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 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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