FORM 1023-EZ for LAKE STATION FIRE DEPARTMENT INC

Field Data
EIN 86-3719634
Case Number EO-2021140-000433
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LAKE STATION FIRE DEPARTMENT INC
Organization’s Mailing Address 1876 FAIRVIEW AVE
City LAKE STATION
State IN
ZIP 46405
Accounting period End 12
Primary contact name GREGORY WOELK SR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOSHWA SMITH
PRESIDENT
4435 LIVERPOOL RD
LAKE STATION IN 46405

Officer/Director/Trustee Two

GREGORY WOELK SR
TREASURER
2924 MIAMI ST
LAKE STATION IN 46405

Officer/Director/Trustee Three

DAVID LEWIN
TRUSTEE
534 E 37TH AVE LOT 689
HOBART IN 46342

Officer/Director/Trustee Four

ANDREW MONAHAN
TRUSTEE
1001 29TH AVE
LAKE STATION IN 46405

Officer/Director/Trustee Five

BENJAMIN PEREZ
TRUSTEE
2278 VANDERBURG ST
LAKE STATION IN 46405

Organization’s website
Organization’s email GWOELK@LAKESTATION-IN.GOV
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/10/2021
Organization Incorporation State IN
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 Yes
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 Yes
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 GREGORY WOELK SR
Signature Title TREASURER
Signature Date 5/13/2021

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