FORM 1023-EZ for FLOYD COUNTY EMS ASSOCIATION INC

Field Data
EIN 87-2421427
Case Number EO-2021250-000280
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name FLOYD COUNTY EMS ASSOCIATION INC
Organization’s Mailing Address 501 6TH AVENUE
City CHARLES CITY
State IA
ZIP 50616
Accounting period End 12
Primary contact name BRANDY MOLITOR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BRANDY MOLITOR
PRESIDENT
501 6TH AVENUE
CHARLES CITY IA 50616

Officer/Director/Trustee Two

KRISTIN GEORGE
SECRETARY
208 3RD AVENUE
CHARLES CITY IA 50616

Organization’s website
Organization’s email BMITTELSTADT@HOTMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/30/2021
Organization Incorporation State IA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E62 - Ambulance, Emergency Medical Transport Services
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 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 BRANDY MOLITOR
Signature Title PRESIDENT
Signature Date 9/2/2021

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