FORM 1023-EZ for ARBALA VOLUNTEER FIRE DEPARTMENT

Field Data
EIN 71-0871399
Case Number EO-2021064-001270
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ARBALA VOLUNTEER FIRE DEPARTMENT
Organization’s Mailing Address 393 CR 1198
City YANTIS
State TX
ZIP 75497
Accounting period End 12
Primary contact name CLAY BARTLEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BRIAN FAIRCHILD
PRESIDENT
2484 FM 1567 W
SULPHUR SPRINGS TX 75482

Officer/Director/Trustee Two

JEFF BLOODGOOD
VICE PRESIDENT
1673 CR 1195
YANTIS TX 75497

Officer/Director/Trustee Three

CLAY BARTLEY
SECRETARY/TREASURER
393 CR 1198
YANTIS TX 75497

Officer/Director/Trustee Four

KAREN LOZANO
ADVISOR
1361 CR 1195
YANTIS TX 75497

Organization’s website
Organization’s email claybo1708@yahoo.com
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/22/2002
Organization Incorporation State TX
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: 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 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 CLAY BARTLEY
Signature Title SECRETARY/TREASURER
Signature Date 1/11/2021

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