FORM 1023-EZ for ASSOCIATION OF ACTIVE FIREFIGHTERSOF RURAL VOLUNTEER FIRE DEPARTMENT

Field	Data
EIN	82-3872079
Case Number	EO-2018190-000606
Form 1023-EZ version	12018
Eligibility Worksheet	1
Organization Name	ASSOCIATION OF ACTIVE FIREFIGHTERSOF RURAL VOLUNTEER FIRE DEPARTMENT
Organization’s Mailing Address	15452 BEAVER MARSH ROAD
City	MOUNT VERNON
State	WA
ZIP	98273
Accounting period End	12
Primary contact name	JON VANDER KOOY
Primary contact phone	[Hidden]
Primary contact phone extension	[Hidden]
Primary contact fax	[Hidden]
User fee submitted	$275.00

Officer/Director/Trustee One

ALEX CARLSON
PRESIDENT
14836 AVON ALLEN ROAD
MOUNT VERNON WA 98273

Officer/Director/Trustee Two

ALBERT HOWARD
VICE PRESIDENT
17436 BENNETT ROAD
MOUNT VERNON WA 98273

Officer/Director/Trustee Three

AMBER MOORE
SECRETARY
16973 VAUGHN ROAD
MOUNT VERNON WA 98273

Officer/Director/Trustee Four

DAN VANDERKOOY
TREASURER
14730 YOUNG ROAD
MOUNT VERNON WA 98273

Organization’s website
Organization’s email
Organization Incorporated	Yes
Organization trust	No
Necessary Organizing Documents	Yes
Organization Incorporation Date	4/22/94
Organization Incorporation State	WA
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	DAN VANDERKOOY
Signature Title	TREASURER
Signature Date	7/6/18
EIN	82-3872079
Case Number	EO-2018190-000606
Form 1023-EZ version	12018
Eligibility Worksheet	1
Organization Name	ASSOCIATION OF ACTIVE FIREFIGHTERS OF RURAL VOLUNTEER FIRE DEPARTMENT
Organization’s Mailing Address	15452 BEAVER MARSH ROAD
City	MOUNT VERNON
State	WA
ZIP	98273
Accounting period End	12
Primary contact name	JON VANDER KOOY
Primary contact phone	[Hidden]
Primary contact phone extension	[Hidden]
Primary contact fax	[Hidden]
User fee submitted	$275.00