FORM 1023-EZ for FRIENDS OF BENNETT FIRE DEPARTMENT

Field Data
EIN 47-1169348
Case Number EO-2016084-000352
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name FRIENDS OF BENNETT FIRE DEPARTMENT
Organization’s Mailing Address 11491 E OSTENSON RD
City LAKE NEBAGAMON
State WI
ZIP 54849-0517
Accounting period End 12
Primary contact name H RICHARD THEIEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

THOMAS BURFIELD
PRESIDENT
9068 E CTY RD L
BENNETT WI 54873

Officer/Director/Trustee Two

TRAVIS THEIEN
SECRETARY
8998 E TOWN LINE RD
BENNETT WI 54873

Officer/Director/Trustee Three

JOSEPH MELLER
DIRECTOR
9115 E HAGMAN RD
BENNETT WI 54873

Officer/Director/Trustee Four

DAVID DITTBRENDER
DIRECTOR
9022 E HAGMAN RD
BENNETT WI 54873

Officer/Director/Trustee Five

RICHARD THEIEN
DIRECTOR
11491 E OSTENSON RD
LAKE NEBAGAMON WI 54849-0517

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/27/2014
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code M11 - Single Organization Support
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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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