FORM 1023-EZ for PETALUMA FIREFIGHTERS FOUNDATION

Field Data
EIN 83-2569965
Case Number EO-2019092-000294
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PETALUMA FIREFIGHTERS FOUNDATION
Organization’s Mailing Address PO BOX 750065
City PETALUMA
State CA
ZIP 94975
Accounting period End 12
Primary contact name PETER LEWICKI
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KEN DICK
PRESIDENT
PO BOX 750065
PETALUMA CA 94975

Officer/Director/Trustee Two

MATTHEW MARTIN
TREASURER
PO BOX 750065
PETALUMA CA 94975

Officer/Director/Trustee Three

ZACHARY BROWN
SECRETARY
PO BOX 750065
PETALUMA CA 94975

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/25/19
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code M20 - Disaster Preparedness and Relief Services
Organization’s purpose Charitable: Yes
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 Yes
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 Yes
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 ZACHARY BROWN
Signature Title SECRETARY
Signature Date 3/29/19

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