FORM 1023-EZ for HICKORY VALLEY VOLUNTEER FIRE DEPARTMET

Field Data
EIN 62-1612972
Case Number EO-2015168-000155
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HICKORY VALLEY VOLUNTEER FIRE DEPARTMET
Organization’s Mailing Address PO BOX 6144
City SPARTA
State TN
ZIP 38583
Accounting period End 6
Primary contact name TYLER BRANDES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

TYLER BRANDES
CHIEF
1009 SKYLINE DRIVE
SPARTA TN 38583

Officer/Director/Trustee Two

ROGER WILSON
TREASURER
536 BUTTS BRIDGE ROAD
SPARTA TN 38583

Officer/Director/Trustee Three

MASON BROCK
ASSISTANT CHIEF
377 SOUTH HICKORY VALLEY ROAD
SPARTA TN 38583

Officer/Director/Trustee Four

DAVID GUY
CAPTAIN
8441 HICKORY VALLEY ROAD
SPARTA TN 38583

Officer/Director/Trustee Five

RICHARD GARRELL
LIEUTENANT
999 SUMMINGS CHAPEL ROAD
SPARTA TN 38583

Organization’s website
Organization’s email HVFD@BLOMAND.NET
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/1/1983
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code M24 - Fire Prevention, Protection, Control
Organization’s purpose Charitable: No
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 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
Signature Title
Signature Date

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