FORM 1023-EZ for AMBULANCE GATEWAY INC

Field Data
EIN 46-4476019
Case Number EO-2014318-000254
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name AMBULANCE GATEWAY INC
Organization’s Mailing Address 2220 S FRASER ST UNIT 1
City AURORA
State CO
ZIP 80014-4508
Accounting period End 12
Primary contact name MARILYN R BURNSIDE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

CHARLES HARTNEY
PRESIDENT
2220 S FRASER ST UNIT 1
AURORA CO 80014-4508

Officer/Director/Trustee Two

MARILYN BURNSIDE
TREASURER
2220 S FRASER ST UNIT 1
AURORA CO 80014-4508

Officer/Director/Trustee Three

BONNIE OHR
DIRECTOR
2220 S FRASER ST UNIT 1
AURORA CO 80014-4508

Officer/Director/Trustee Four

DONALD METZ
DIRECTOR
2220 S FRASER ST UNIT 1
AURORA CO 80014-4508

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/9/2014
Organization Incorporation State CO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T50 - Philanthropy, Charity, Voluntarism Promotion, General
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 Yes
One Third Support Gifts No
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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