FORM 1023-EZ for EASTERN NEBRASKA WESTERN IOWA MEDICAL RESERVE CORPS
| Field | Data |
|---|---|
| EIN | 81-2856933 |
| Case Number | EO-2016216-000131 |
| Form 1023-EZ version | 62014 |
| Eligibility Worksheet | 1 |
| Organization Name | EASTERN NEBRASKA WESTERN IOWA MEDICAL RESERVE CORPS |
| Organization’s Mailing Address | 2401 SO 73RD ST SUITE 200 |
| City | OMAHA |
| State | NE |
| ZIP | 68124 |
| Accounting period End | 5 |
| Primary contact name | PAMELA DENNEY |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
PAMELA DENNEY
EXECUTIVE DIRECTOR
104 KINGS DRIVE
BELLEVUE NE 68005
Officer/Director/Trustee Two
DALE TEDDER
SECRETARY/TREASURER
3901 PLATTEVIEW ROAD
BELLEVUE NE 68123
Officer/Director/Trustee Three
THERESA HATCHER
BOARD MEMBER
101 MARTIN DRIVE
BELLEVUE NE 68005
Officer/Director/Trustee Four
MICHAEL GOOCH
BOARD MEMBER
P O BOX 540938
OMAHA NE 68154
Officer/Director/Trustee Five
TERRY MILLER
BOARD MEMBER
387 NORTH CHESTNUT
WAHOO NE 68066
| Organization’s website | N/A |
|---|---|
| Organization’s email | PAMELA.DENNEY@ALEGENT.ORG |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 5/10/2016 |
| Organization Incorporation State | NE |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | M19 - Nonmonetary Support N.E.C. |
| Organization’s purpose | Charitable: Yes Religious: No Educational: No 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 | 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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