FORM 1023-EZ for HOLLAND VOLUNTEER FIRE DEPARTMENT INC

Field Data
EIN 90-0474806
Case Number EO-2015216-000057
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HOLLAND VOLUNTEER FIRE DEPARTMENT INC
Organization’s Mailing Address P O BOX 7236
City SUFFOLK
State VA
ZIP 23437-0236
Accounting period End 6
Primary contact name CHIEF MARK ELLIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

HEATHER WIDENER
PRESIDENT
4070 VICKSBURG RD
SUFFOLK VA 23437-0236

Officer/Director/Trustee Two

JOE DRAKE
VICE PRESIDENT
543-A BROAD ST
PORTSMOTH VA 23707-9998

Officer/Director/Trustee Three

MARY WILLIAM BAINES
SECRETARY
6701 INDIAN TRAIL
SUFFOLK VA 23437-0236

Officer/Director/Trustee Four

MARK ELLIS
CHIEF OF DEPARTMENT
1048 KINGSALE RD
SUFFOLK VA 23437-0236

Organization’s website
Organization’s email MARK.ELLIS@VDOT.VIRGINIA.GOV
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/19/2010
Organization Incorporation State VA
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 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
Signature Title
Signature Date

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