FORM 1023-EZ for CENTRAL COUNTY FIRE AND RESCUE REHAB95

Field Data
EIN 84-3032876
Case Number EO-2019277-000806
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CENTRAL COUNTY FIRE AND RESCUE REHAB95
Organization’s Mailing Address 1020 CAVE SPRING BLVD
City SAINT PETERS
State MO
ZIP 63376-6429
Accounting period End 12
Primary contact name MARK RUNGE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MARK RUNGE
PRESIDENT-REHAB95
1020 CAVE SPRING BLVD
ST. PETERS MO 63376-6429

Officer/Director/Trustee Two

BRIAN BEASLEY
TREASURER-REHAB95
1020 CAVE SPRING BLVD
SAINT PETERS MO 63376-6429

Officer/Director/Trustee Three

SUSAN HEREDIA
SECRETARY-REHAB95
1020 CAVE SPRING BLVD
SAINT PETERS MO 63376-6429

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/17/19
Organization Incorporation State MO
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 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 MARK RUNGE
Signature Title PRESIDENT-REHAB95
Signature Date 10/2/19

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