FORM 1023-EZ for OAK CREEK GRADE VOLUNTEER FIRE DEPARTMENT

Field Data
EIN 84-1733147
Case Number EO-2019316-000448
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name OAK CREEK GRADE VOLUNTEER FIRE DEPARTMENT
Organization’s Mailing Address 114 COUNTY ROAD 66
City WESTCLIFFE
State CO
ZIP 81252
Accounting period End 12
Primary contact name JANIE M CARPER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KEVIN COWAN
PRESIDENT
275 CR 277
CANON CITY CO 81212

Officer/Director/Trustee Two

TERRI BERG
SECRETARY
44 CHINOOK DRIVE
CANON CITY CO 81212

Officer/Director/Trustee Three

ELIZABETH GODDARD
TREASURER
114 CR 66
WESTCLIFFE CO 81252

Officer/Director/Trustee Four

BOBBY GOSS
BOARD MEMBER
244 PIUTE CIRCLE
CANON CITY CO 81212

Officer/Director/Trustee Five

DAVID MILLER
BOARD MEMBER
422 CHINOOK DRIVE
CANON CITY CO 81212

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/14/18
Organization Incorporation State CO
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: 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 KEVIN COWAN
Signature Title PRESIDENT
Signature Date 11/9/19

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