FORM 1023-EZ for HINDMAN VOLUNTEER FIRE DEPARTMENT

Field Data
EIN 61-1166356
Case Number EO-2015162-000299
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HINDMAN VOLUNTEER FIRE DEPARTMENT
Organization’s Mailing Address 89 COWTOWN ROAD- BOX 299
City HINDMAN
State KY
ZIP 41822-0299
Accounting period End 12
Primary contact name BENNY BAILEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JAMES HAYS
CHAIR
89 COWTOWN RD
HINDMAN KY 41822

Officer/Director/Trustee Two

NATHAN COUCH
VICE CHAIR
89 COWTOWN RD
HINDMAN KY 41822

Officer/Director/Trustee Three

BENNY BAILEY
SEC/TREAS
89 COWTOWN RD
HINDMAN KY 41822

Officer/Director/Trustee Four

BEN MARTIN
BOARD MEMBER
89 COWTOWN RD
HINDMAN KY 41822

Officer/Director/Trustee Five

GREGG MULLINS
BOARD MEMBER
89 COWTOWN RD
HINDMAN KY 41822

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/27/1969
Organization Incorporation State KY
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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