| Field | Data |
|---|---|
| EIN | 42-1173557 |
| Case Number | EO-2016049-000107 |
| Form 1023-EZ version | 62014 |
| Eligibility Worksheet | 1 |
| Organization Name | ANDOVER COMMUNITY AMBULANCE SERVICE |
| Organization’s Mailing Address | 1367 WASHINGTON STREET |
| City | ANDTOVER |
| State | IA |
| ZIP | 52071-0055 |
| Accounting period End | 12 |
| Primary contact name | RANDALL WILCKE |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $400.00 |
WAYNE HARMSEN
PRESIDENT
4362 150TH STREET
CLINTON IA 52732
BEN JOHNSON
VICE-PRESIDENT
2418 NORTH 10TH STREET
CLINTON IA 52732
MARCY WILCKE
SECRETARY
1234 425TH AVE
CLINTON IA 52732-8719
RANDALL WILCKE
TREASURER
1264 425TH AVE
CLINTON IA 52732-8719
| Organization’s website | |
|---|---|
| Organization’s email | ANDOVERFIRE@NETINS.NET |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 6/25/1981 |
| Organization Incorporation State | IA |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | E62 - Ambulance, Emergency Medical Transport Services |
| 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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