FORM 1023-EZ for PARK CITY AND RURAL FIRE DEPARTMENTINC

Field Data
EIN 82-1309670
Case Number EO-2017117-000433
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PARK CITY AND RURAL FIRE DEPARTMENTINC
Organization’s Mailing Address PO BOX 502
City PARK CITY
State MT
ZIP 59063
Accounting period End 12
Primary contact name KELLAN KAMERZEL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DAN BUCKLEY
59063-0000
PO BOX 502
PARK CITY MT 59063

Officer/Director/Trustee Two

TED GOLDY
VISE PRESIDENT
PO BOX 502
PARK CITY MT 59063

Officer/Director/Trustee Three

JUSTIN STRECK
TREASURER
PO BOX 502
PARK CITY MT 59063

Officer/Director/Trustee Four

TAYLOR CLARK
SECRETARY
PO BOX 502
PARK CITY MT 59063

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/17/2016
Organization Incorporation State MT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code M24 - Fire Prevention, Protection, Control
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 Yes
Disaster relief assistance No
One Third Support Public No
One Third Support Gifts Yes
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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