FORM 1023-EZ for FOUNTAIN COUNTY EMS ASSOCIATION

Field Data
EIN 81-0878049
Case Number EO-2019284-000297
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name FOUNTAIN COUNTY EMS ASSOCIATION
Organization’s Mailing Address 409 E 50 S
City VEEDERSBURG
State IN
ZIP 47987
Accounting period End 12
Primary contact name ADAM NOGGLE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JESSICA FOUST
PRESIDENT
409 E 50 S
VEEDERSBURG IN 47987

Officer/Director/Trustee Two

JEFF HUTCHISON
VICE PRESIDENT
409 E 50 S
VEEDERSBURG IN 47987

Officer/Director/Trustee Three

NICOLE MCMASTERS
SECRETARY
409 E 50 S
VEEDERSBURG IN 47987

Officer/Director/Trustee Four

ADAM NOGGLE
TREASURER
409 E 50 S
VEEDERSBURG IN 47987

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/21/15
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code M01 - Alliance/Advocacy Organizations
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 ADAM NOGGLE
Signature Title TREASURER
Signature Date 10/8/19

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