FORM 1023-EZ for ST LOUIS FIRE ON ICE

Field Data
EIN 82-4664807
Case Number EO-2018073-000092
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ST LOUIS FIRE ON ICE
Organization’s Mailing Address 647 THICKET LN
City LAKE ST LOUIS
State MO
ZIP 63367
Accounting period End 8
Primary contact name JOSH DORTCH 314-584-0356
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOSHUA DORTCH
BOARD MEMBER
647 THICKET LN
LAKE ST LOUIS MO 63367

Officer/Director/Trustee Two

NICK AUBUCHON
BOARD MEMBER
134 CENTRAL PARK AVE
FORISTELL MO 63348

Officer/Director/Trustee Three

AARON CIZEK
BOARD MEMBER
9626 MAGNOLIA DR
HILSBORO MO 63050

Organization’s website STLFIREONICE.COM
Organization’s email STLOUISFIREEMSHOCKEY@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/28/17
Organization Incorporation State MO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code M60 - Public Safety
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 JOSHUA DORTCH
Signature Title BOARD MEMBER
Signature Date 3/12/18

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