FORM 1023-EZ for EAST PALATKA VOLUNTEER FIRE DEPARTMENT

Field Data
EIN 46-2822791
Case Number EO-2018323-000278
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name EAST PALATKA VOLUNTEER FIRE DEPARTMENT
Organization’s Mailing Address 158 LOUIS BROER ROAD
City EAST PALATKA
State FL
ZIP 32131
Accounting period End 9
Primary contact name SAMUEL SCHALLER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JESSICA BOUCHEZ
PRESIDENT
154 C GILBERT ROAD
EAST PALATKA FL 32131

Officer/Director/Trustee Two

GENE BOUCHEZ
VICE PRESIDENT
154 C GILBERT ROAD
EAST PALATKA FL 32131

Officer/Director/Trustee Three

BREANA BATEMAN
SECRETARY
124 GRANDVIEW DRIVE
EAST PALATKA FL 32131

Officer/Director/Trustee Four

TIFFANY MANNING
TREASURER
7043-1 SILVER LAKE RD
PALATKA FL 32177

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/7/61
Organization Incorporation State FL
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: Yes
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 Yes
Correctness Declaration Yes
Signature Name GENE BOUCHEZ
Signature Title VICE PRESIDENT
Signature Date 11/15/18

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