FORM 1023-EZ for CHAFFEE COUNTY EMS FOUNDATION INC

Field Data
EIN 20-3202499
Case Number EO-2015220-000013
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CHAFFEE COUNTY EMS FOUNDATION INC
Organization’s Mailing Address BOX 388
City PONCHA SPRINGS
State CO
ZIP 81242
Accounting period End 12
Primary contact name CLIFFORD A MESTEL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

GEORGIA BERNDT
PRESIDENT
647 HUNT STREET
SALIDA CO 81201

Officer/Director/Trustee Two

CLIFFORD A MESTEL
SECRETARY-TREASURER
12874 COUNTY ROAD 314B
BUENA VISTA CO 81211

Officer/Director/Trustee Three

STEWART PAPPENFORT
DIRECTOR
308 PALMER STREET
SALIDA CO 81201

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/22/2005
Organization Incorporation State CO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code M12 - Fund Raising and/or Fund Distribution
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 No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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