FORM 1023-EZ for KANSAS AIR MEDICAL TRANSPORT SOCIETY

Field Data
EIN 81-2927228
Case Number EO-2016193-000317
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name KANSAS AIR MEDICAL TRANSPORT SOCIETY
Organization’s Mailing Address 6520 SE FORBES AVE
City TOPEKA
State KS
ZIP 66619
Accounting period End 12
Primary contact name ROD PACE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ROD PACE
PRESIDENT
1110 WOODLAND DR
WEBB CITY MO 64870

Officer/Director/Trustee Two

FRANK WILLIAMS
VICE PRESIDENT
4843 SW COUNTRY LN
EL DORADO KS 67042

Officer/Director/Trustee Three

STACY CROOMES
SECRETARY/TREASURER
2815 W 28TH AVE
STILLWATER OK 74074

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/14/2016
Organization Incorporation State KS
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E03 - Professional Societies, Associations
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
Signature Title
Signature Date

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