FORM 1023-EZ for BLUFFTON EMERGENCY SERVICES CHARITIES

Field Data
EIN 38-3980019
Case Number EO-2016022-000139
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BLUFFTON EMERGENCY SERVICES CHARITIES
Organization’s Mailing Address 154 NORTH MAIN ST
City BLUFFTON
State OH
ZIP 45817
Accounting period End 12
Primary contact name F STEPHEN CHAMBERLAIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

RICK SKILLITER
OFFICER
623 HARMON RD
BLUFFTON OH 45817

Officer/Director/Trustee Two

TYLER HOCHSTETLER
OFFICER
603 HARMON RD
BLUFFTON OH 45817

Officer/Director/Trustee Three

JON KINN
OFFICER
231 S MAIN ST
BLUFFTON OH 45817

Officer/Director/Trustee Four

BLANE MILLER
OFFICER
135 SHANNON ST
BLUFFTON OH 45817

Officer/Director/Trustee Five

JAN BASINGER
OFFICER
144 HILLCREST DR
BLUFFTON OH 45817

Organization’s website N/A
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/1/2014
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code M11 - Single Organization Support
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
Signature Title
Signature Date

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