FORM 1023-EZ for PLEASANT HILL FIRE PROTECTION DISTRICT

Field Data
EIN 37-1147103
Case Number EO-2016239-000159
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PLEASANT HILL FIRE PROTECTION DISTRICT
Organization’s Mailing Address 405 BOTTOM ST
City PLEASANT HILL
State IL
ZIP 62366
Accounting period End 4
Primary contact name SHANNON SMITH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JAMES VAN DYNE
TRUSTEE PRESIDENT
RR1
NEBO IL 62366

Officer/Director/Trustee Two

JERRY HOUGLAND
TRUSTEE TREASURE
120 KING RD
PLEASANT HILL IL 62366

Officer/Director/Trustee Three

JAMES LEEDS
TRUSTEE SECRETARY
HARMAN ST
PLEASANT HILL IL 62366

Officer/Director/Trustee Four

SHANNON SMITH
FIRE CHIEF
307 E CLAY ST
PLEASANT HILL IL 62366

Officer/Director/Trustee Five

JODY COY
ASSTISTANT FIRE CHIEF
303 HOWARD ST
PLEASANT HILL IL 62366

Organization’s website
Organization’s email PHFPD@IRTC.NET
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/1/1956
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Z99 - Unclassified
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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