FORM 1023-EZ for MAXWELL EMS INCORPORATED

Field Data
EIN 47-2490703
Case Number EO-2015267-000264
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MAXWELL EMS INCORPORATED
Organization’s Mailing Address 111 MAIN ST
City MAXWELL
State IA
ZIP 50161
Accounting period End 6
Primary contact name NANCY PRITCHARD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

NANCY PRITCHARD
DIRECTOR
66308 295TH ST
MAXWELL IA 50161

Officer/Director/Trustee Two

DEE GAMBLE
DIRECTOR
66308 295TH ST
MAXWELL IA 50161

Officer/Director/Trustee Three

MICK CAIRNS
DIRECTOR
802 ROCK CREEK DR
MAXWELL IA 50161

Officer/Director/Trustee Four

JAMIE NESS
DIRECTOR
603 ROCK CREEK DR
MAXWELL IA 50161

Officer/Director/Trustee Five

SUSAN LIVESAY
DIRECTOR
201 WOODLAWN
MAXWELL IA 50161

Organization’s website
Organization’s email MAXWELLEMSDEPT@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/6/2014
Organization Incorporation State IA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G12 - 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 No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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