FORM 1023-EZ for BANGOR-BURNS FIRE DEPARTMENT FAMILYAUXILIARY INC

Field Data
EIN 46-1112114
Case Number EO-2015289-000150
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BANGOR-BURNS FIRE DEPARTMENT FAMILYAUXILIARY INC
Organization’s Mailing Address 200 SOUTH COMMERCIAL ST PO BOX 223
City ROCKLAND
State WI
ZIP 54653
Accounting period End 12
Primary contact name PAMELA HOTH -TREASURER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

SALLY RUECKHEIM
PRESIDENT
305 E ROCK ST
ROCKLAND WI 54653

Officer/Director/Trustee Two

STEPHANIE TOLLEFSON
VICE PRESIDENT
401 N 18TH AVE
BANGOR WI 54614

Officer/Director/Trustee Three

TIFFANY JANISCH
SECRETARY
PO BOX 45
BANGOR WI 54614

Officer/Director/Trustee Four

PAMELA HOTH
TREASURER
306 N 17TH AVE
BANGOR WI 54614

Officer/Director/Trustee Five

GRETCHEN ECKLAND
CO-TREASURER
N4381 FRITZ SCHROEDER RD
BANGOR WI 54614

Organization’s website
Organization’s email BBFDFA@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/24/2012
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement Yes
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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