FORM 1023-EZ for KILROY BAY & PINE COVE VOLUNTEER FIRE DEPARTMENT

Field Data
EIN 82-1847194
Case Number EO-2019121-000028
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name KILROY BAY & PINE COVE VOLUNTEER FIRE DEPARTMENT
Organization’s Mailing Address 5811 N RAMBO RD
City SPOKANE
State WA
ZIP 99224-9175
Accounting period End 12
Primary contact name NANCY KVAMME
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DOUGLAS PETERS
FIRE CHIEF
13528 S VALLEY CHAPEL RD
VALLEYFORD WA 99036

Officer/Director/Trustee Two

NANCY KVAMME
SECRETARY TREASURER
5811 N RAMBO RD
SPOKANE WA 99224-9175

Officer/Director/Trustee Three

JIM MILLER
BOARD MEMBER
7124 E BRIDGEPORT AVE
SPOKANE WA 99212-1513

Officer/Director/Trustee Four

RICH PICKENS
BOARD MEMBER
803 E MAPLE PL
HAYDEN ID 83835

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/15/18
Organization Incorporation State ID
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: 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 NANCY KVAMME
Signature Title SECRETARY TREASURER
Signature Date 4/27/19

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