FORM 1023-EZ for GLADBROOK-LINCOLN AMBULANCE FOUNDATION INC

Field Data
EIN 82-1271595
Case Number EO-2017121-000274
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name GLADBROOK-LINCOLN AMBULANCE FOUNDATION INC
Organization’s Mailing Address 1254 HIGHWAY 96 PO BOX 309
City GLADBROOK
State IA
ZIP 50635-0309
Accounting period End 12
Primary contact name RYAN SUTCLIFFE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RYAN SUTCLIFFE
PRESIDENT
1731 B AVE
GLADBROOK IA 50635

Officer/Director/Trustee Two

RANDY BEICHLEY
VICE-PRESIDENT
1211 200TH ST
GLADBROOK IA 50635

Officer/Director/Trustee Three

BETH BRUBAKER
CO-SECRETARY
613 6TH ST
GLADBROOK IA 50635

Officer/Director/Trustee Four

KATHY VAVROCH
CO-SECRETARY
207 2ND ST
GLADBROOK IA 50635

Officer/Director/Trustee Five

SUSAN BEICHLEY
TREASURER
1211 200TH ST
GLADBROOK IA 50635

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/26/2017
Organization Incorporation State IA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E12 - 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
Signature Title
Signature Date

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