FORM 1023-EZ for GRAND GORGE HOSE COMPANY

Field Data
EIN 30-0597208
Case Number EO-2016126-000266
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name GRAND GORGE HOSE COMPANY
Organization’s Mailing Address PO BOX 40
City GRAND GORGE
State NY
ZIP 12434
Accounting period End 12
Primary contact name WAYNE WYCKOFF
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JAMES HULL
PRESIDENT
1041 JOHNSON HOLLOW RD
PRATTSVILLE NY 12468

Officer/Director/Trustee Two

DAN BALLARD
VICE PRSIDENT
PO BOX 282
GRAND GORGE NY 12434-0282

Officer/Director/Trustee Three

DAN PICKETT
SECRATARY
PO BOX 92
GRAND GORGE NY 12434-0092

Officer/Director/Trustee Four

WAYNE WYCKOFF
TRESURER
PO BOX 55
GRAND GORGE NY 12434-0055

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date ###############################################################################################################################################################################################################################################################
Organization Incorporation State NY
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 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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