FORM 1023-EZ for HARLAN FIREFIGHTERS ASSOCIATION INC

Field Data
EIN 81-4103915
Case Number EO-2020132-000247
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HARLAN FIREFIGHTERS ASSOCIATION INC
Organization’s Mailing Address 711 DURANT STREET
City HARLAN
State IA
ZIP 51537-0001
Accounting period End 12
Primary contact name TIM PEDERSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TIM PEDERSON
DIRECTOR, PRESIDENT
1509 19TH STREET
HARLAN IA 51537

Officer/Director/Trustee Two

CONNIE MILLER
DIRECTOR
1220 BALDWIN STREET
HARLAN IA 51537

Officer/Director/Trustee Three

ROBIN BUTLER
DIRECTOR
1307 BALDWIN STREET
HARLAN IA 51537

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/27/2016
Organization Incorporation State IA
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name TIM PEDERSON
Signature Title DIRECTOR, PRESIDENT
Signature Date 5/7/2020
EIN 81-4103915
Case Number EO-2016288-000299
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HARLAN FIREFIGHTERS ASSOCIATION INC
Organization’s Mailing Address 711 DURANT STREET
City HARLAN
State IA
ZIP 51537
Accounting period End 11
Primary contact name DANIEL P FISCHER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TIM PEDERSON
DIRECTOR
1509 19TH STREET
HARLAN IA 51537

Officer/Director/Trustee Two

CHAD KROGER
DIRECTOR
1508 8TH STREET
HARLAN IA 51537

Officer/Director/Trustee Three

JESSE RUDOLPH
DIRECTOR
1607 ERIE DRIVE
HARLAN IA 51537

Officer/Director/Trustee Four

ROBIN BUTLER
TREASURER
1608 20TH STREET
HARLAN IA 51537

Officer/Director/Trustee Five

KRISTI PEDERSON
SECRETARY
1509 19TH STREET
HARLAN IA 51537

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/27/2016
Organization Incorporation State IA
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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