FORM 1023-EZ for CHALYBEATE VOLUNTEER FIRE DEPT

Field Data
EIN 84-4434987
Case Number EO-2020041-000700
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CHALYBEATE VOLUNTEER FIRE DEPT
Organization’s Mailing Address PO BOX 247
City BROWNSVILLE
State KY
ZIP 42210
Accounting period End 12
Primary contact name ROBIN VINCENT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOE DURBIN
CHAIRMAN
1135 CHALYBEATE RD
SMITHS GROVE KY 42171

Officer/Director/Trustee Two

DANNY GOINS
VICE-CHAIRMAN
2380 SULPHER RD
SMITHS GROVE KY 42171

Officer/Director/Trustee Three

SCOTT SKAGGS
BOARD MEMBER
56 CHAPEL CENTER LANE
SMTIHS GROVE KY 42171

Officer/Director/Trustee Four

TRAVIS MADISON
BOARD MEMBER
854 ARTHUR RD
SMITHS GROVE KY 42171

Officer/Director/Trustee Five

ROBIN VINCENT
SECRETARY/TREASURER
405 CHALYBEATE ROAD
SMITHS GROVE KY 42171

Organization’s website
Organization’s email CVFDKY@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/31/1989
Organization Incorporation State KY
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: Yes
Scientific: No
Literary: No
Public Safety: Yes
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name ROBIN VINCENT
Signature Title SECRETARY/TREASURER
Signature Date 2/8/2020

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