FORM 1023-EZ for MT UNION FIRE DEPARTMENT FOUNDATION

Field Data
EIN 84-2173977
Case Number EO-2019176-000487
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MT UNION FIRE DEPARTMENT FOUNDATION
Organization’s Mailing Address 208 S ROADS STREET
City MT UNION
State IA
ZIP 52644
Accounting period End 6
Primary contact name JEANNE DAVIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHAWN BENCZE
PRESIDENT
800 N PALM AVE
MT PLEASANT IA 52641

Officer/Director/Trustee Two

SCOTT PFEIFFER
SEC
208 E SPAHR ST
MT UNION IA 52644

Officer/Director/Trustee Three

ANDREW GRIESER
TREAS
208 S ROADS ST
MT UNION IA 52644

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/21/19
Organization Incorporation State IA
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 No
Correctness Declaration Yes
Signature Name ANDREW GRIESER
Signature Title TREAS
Signature Date 6/21/19

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