FORM 1023-EZ for VINCENT FIRE DEPARTMENT AMBULANCEINC

Field Data
EIN 45-4460186
Case Number EO-2014307-000380
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name VINCENT FIRE DEPARTMENT AMBULANCEINC
Organization’s Mailing Address 102 S 1ST ST
City VINCENT
State IA
ZIP 50594
Accounting period End 12
Primary contact name HEATHER DENCKLAU
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

GARY MILLER
CHIEF
406 ARTHUR ST
VINCENT IA 50594

Officer/Director/Trustee Two

CHERYL RITENOUR
SECRETARY/TREASURER
203 JOHNSON ST
VINCENT IA 50594

Officer/Director/Trustee Three

HEATH MILLER
PRESIDENT
304 LAWRENCE ST
VINCENT IA 50594

Officer/Director/Trustee Four

JUDY MCBETH
EMS DIRECTOR
210 LAWRENCE ST
VINCENT IA 50594

Organization’s website
Organization’s email VINCENTEMS@WCCTA.NET
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/18/2003
Organization Incorporation State IA
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: Yes
Educational: Yes
Scientific: Yes
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 No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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