FORM 1023-EZ for WISCONSIN ASSOCIATION OF EMERGENCYVEHICLE TECHNICIANS INC

Field Data
EIN 81-2001152
Case Number EO-2018295-000028
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name WISCONSIN ASSOCIATION OF EMERGENCYVEHICLE TECHNICIANS INC
Organization’s Mailing Address N6628 THOMPSON ROAD
City BEAVER DAM
State WI
ZIP 53916
Accounting period End 5
Primary contact name JON COUTTS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JON COUTTS
PRESIDENT & DIRECTOR
905 KINGS RIDGE COURT E
WEST BEND WI 53090

Officer/Director/Trustee Two

TOM THIELE
VICE PRESIDENT & DIRECTOR
319 ARBOR RIDGE DRIVE
DELAVAN WI 53115

Officer/Director/Trustee Three

BRIAN TOTH
EXEC SECRETARY & DIRECTOR
N6628 THOMPSON ROAD
BEAVER DAM WI 53916

Officer/Director/Trustee Four

RANDY KLAYBOR
TREASURER & DIRECTOR
11130 WOODSIDE DRIVE
HALES CORNERS WI 53130

Officer/Director/Trustee Five

MARVIN BURG
REC SECRETARY & DIRECTOR
N65W23501 MAIN STREET
SUSSEX WI 53089

Organization’s website WWW.WAEVT.COM
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/7/18
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code M99 - Public Safety, Disaster Preparedness, and Relief N.E.C.
Organization’s purpose Charitable: No
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 JON COUTTS
Signature Title PRESIDENT & DIRECTOR
Signature Date 10/18/18
EIN 81-2001152
Case Number EO-2018295-000028
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name WISCONSIN ASSOCIATION OF EMERGENCY VEHICLE TECHNICIANS INC
Organization’s Mailing Address N6628 THOMPSON ROAD
City BEAVER DAM
State WI
ZIP 53916
Accounting period End 5
Primary contact name JON COUTTS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JON COUTTS
PRESIDENT & DIRECTOR
905 KINGS RIDGE COURT E
WEST BEND WI 53090

Officer/Director/Trustee Two

TOM THIELE
VICE PRESIDENT & DIRECTOR
319 ARBOR RIDGE DRIVE
DELAVAN WI 53115

Officer/Director/Trustee Three

BRIAN TOTH
EXEC SECRETARY & DIRECTOR
N6628 THOMPSON ROAD
BEAVER DAM WI 53916

Officer/Director/Trustee Four

RANDY KLAYBOR
TREASURER & DIRECTOR
11130 WOODSIDE DRIVE
HALES CORNERS WI 53130

Officer/Director/Trustee Five

MARVIN BURG
REC SECRETARY & DIRECTOR
N65W23501 MAIN STREET
SUSSEX WI 53089

Organization’s website WWW.WAEVT.COM
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/7/18
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code M99 - Public Safety, Disaster Preparedness, and Relief N.E.C.
Organization’s purpose Charitable: No
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 JON COUTTS
Signature Title PRESIDENT & DIRECTOR
Signature Date 10/18/18

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