FORM 1023-EZ for SOUTHWEST HEATH TRANSPORT INC

Field Data
EIN 86-3048835
Case Number EO-2021103-000731
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SOUTHWEST HEATH TRANSPORT INC
Organization’s Mailing Address 1000 W LOTUS AVE
City ULYSSES
State KS
ZIP 67880
Accounting period End 12
Primary contact name RACHAEL THOOFT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

STEVE BROM
CHAIRMAN
1000 W LOTUS AVE
ULYSSES KS 67880

Officer/Director/Trustee Two

MIKE SALSBURY
VICE PRESIDENT
805 W WHEAT AVE
ULYSSES KS 67880

Officer/Director/Trustee Three

BETH MATHES
SECRETARY
917 N HICKOK ST
ULYSSES KS 67880

Officer/Director/Trustee Four

RUBY ROMERO
DIRECTOR
220 N HICKOK ST
ULYSSES KS 67880

Officer/Director/Trustee Five

JOHN NICKEL
DIRECTOR
706 E WHEAT
ULYSSES KS 67880

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/1/2021
Organization Incorporation State KS
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P52 - Transportation, Free or Subsidized
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
Scientific: Yes
Literary: No
Public Safety: Yes
Amateur Sports: No
Cruelty Prevention: Yes
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 STEVE BROM
Signature Title CHAIRMAN
Signature Date 4/8/2021

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