FORM 1023-EZ for BERLIN EMT ASSOCIATION INC
| Field | Data |
|---|---|
| EIN | 45-2778986 |
| Case Number | EO-2015022-000275 |
| Form 1023-EZ version | 62014 |
| Eligibility Worksheet | 1 |
| Organization Name | BERLIN EMT ASSOCIATION INC |
| Organization’s Mailing Address | PO BOX 183 |
| City | BERLIN |
| State | WI |
| ZIP | 54923 |
| Accounting period End | 12 |
| Primary contact name | ROBERT MALCHETSKE |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $400.00 |
Officer/Director/Trustee One
LARRY HALL
PRESIDENT
163 E LIBERTY ST
BERLIN WI 54923
Officer/Director/Trustee Two
KAMEO JORGENSEN
VICE PRESIDENT
280 RIPON ROAD
BERLIN WI 54923
Officer/Director/Trustee Three
ANTHONY THOMA
TREASURER
175 S JOHNSON ST
BERLIN WI 54923
Officer/Director/Trustee Four
DEE EVANS
SECRETARY
589 SACRAMENTO ST
BERLIN WI 54923
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 11/10/2011 |
| Organization Incorporation State | WI |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | M12 - Fund Raising and/or Fund Distribution |
| 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 | Yes |
| Seeking Section 7 Reinstatement | No |
| Correctness Declaration | Yes |
| Signature Name | |
| Signature Title | |
| Signature Date |
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