FORM 1023-EZ for LINCOLN COUNTY EMS COMMUNITY OUTREACH

Field Data
EIN 82-2690661
Case Number EO-2017251-000475
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LINCOLN COUNTY EMS COMMUNITY OUTREACH
Organization’s Mailing Address 1392 SOUTH 3RD STREET
City TROY
State MO
ZIP 63379
Accounting period End 12
Primary contact name BRETT TICHENOR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PAUL SANSONE
DIRECTOR
1392 SOUTH 3RD STREET
TROY MO 63379

Officer/Director/Trustee Two

BRETT TICHENOR
DIRECTOR
1392 SOUTH 3RD STREET
TROY MO 63379

Officer/Director/Trustee Three

NATHAN SCHNELLE
DIRECTOR
1392 SOUTH 3RD STREET
TROY MO 63379

Officer/Director/Trustee Four

KAITLYN RAFTERY
DIRECTOR
1392 SOUTH 3RD STREET
TROY MO 63379

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/5/2017
Organization Incorporation State MO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W12 - 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: Yes
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 Yes
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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