FORM 1023-EZ for HALIFAX COUNTY FIREFIGHTERS ASSOCIATION

Field Data
EIN 56-2280835
Case Number EO-2016250-000150
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HALIFAX COUNTY FIREFIGHTERS ASSOCIATION
Organization’s Mailing Address PO BOX 308
City HALIFAX
State NC
ZIP 27839
Accounting period End 6
Primary contact name RICHARD PULLEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KEVIN KUPIETZ
PRESIDENT
525 VANCE ST
ROANOKE RAPIDS NC 27870

Officer/Director/Trustee Two

JASON PATRICK
VICE PRESIDENT
285 AIR BASE RD
ROANOKE RAPIDS NC 27870

Officer/Director/Trustee Three

RICHARD PULLEY
TREASURER
3709 HEDGEPETH RD
LITTLETON NC 27850

Officer/Director/Trustee Four

DEBRA HOPKINS
SECRETARY
8355 HWY 258
SCOTLAND NECK NC 27874

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/10/2001
Organization Incorporation State NC
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 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 Yes
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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