FORM 1023-EZ for CITY OF PORT ANGELES FIRE DEPARTMENT AUXILIARY

Field Data
EIN 91-2135819
Case Number EO-2016132-000253
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CITY OF PORT ANGELES FIRE DEPARTMENT AUXILIARY
Organization’s Mailing Address 102 EAST FIFTH STREET
City PORT ANGELES
State WA
ZIP 98362-3014
Accounting period End 12
Primary contact name TERESA DUBUC
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

TAMI ZIEGLER
PRESIDENT
188 BAKER FARM ROAD
PORT ANGELES WA 98362-3014

Officer/Director/Trustee Two

TERESA DUBUC
SECRETARY
7192 LITTLE RIVER RD
PORT ANGELES WA 98362-3014

Officer/Director/Trustee Three

ZOE HANSEN
TREASURER
505 EAST 9TH STREET
PORT ANGELES WA 98362-3014

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/1/2001
Organization Incorporation State WA
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: 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 Yes
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 Yes
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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