FORM 1023-EZ for ASSOCIATION OF LIBERTY COUNTY EMERGENCY SERVICES DISTRICTS

Field Data
EIN 86-1488239
Case Number EO-2021081-000732
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ASSOCIATION OF LIBERTY COUNTY EMERGENCY SERVICES DISTRICTS
Organization’s Mailing Address 1400 CR 2005
City LIBERTY
State TX
ZIP 77575
Accounting period End 12
Primary contact name EMILY COOK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KLINT BUSH
PRESIDENT
1400 CR 2005
LIBERTY TX 77575

Officer/Director/Trustee Two

STEPHANIE JOHNSON
SECRETARY
PO BOX 237
HARDIN TX 77564

Officer/Director/Trustee Three

GUILLERMO GOMEZ
VICE PRESIDENT
3709 FM 1008
DAYTON TX 77535

Officer/Director/Trustee Four

LIN PRUITT
TREASURER
703 MAIN STREET
DAISETTA TX 77533

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/21/2020
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E01 - Alliance/Advocacy Organizations
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: Yes
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 KLINT BUSH
Signature Title PRESIDENT
Signature Date 1/26/2021

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