FORM 1023-EZ for CLAY CITY HARRISON TOWNSHIP VOLUNTEER FIRE DEPARTMENT INC

Field Data
EIN 84-3119090
Case Number EO-2019275-000214
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CLAY CITY HARRISON TOWNSHIP VOLUNTEER FIRE DEPARTMENT INC
Organization’s Mailing Address 403 W 7TH STREET
City CLAY CITY
State IN
ZIP 47841
Accounting period End 12
Primary contact name KEITH GRASSICK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KEITH GRASSICK
PRESIDENT
403 W COUNTY ROAD 700 S
CLAY CITY IN 47841

Officer/Director/Trustee Two

KYLE GRASSICK
VICE PRESIDENT
209 W 14TH STREET
CLAY CITY IN 47841

Officer/Director/Trustee Three

BRIAN REAM
SECRETARY/TREASURER
1801 E COUNTY ROAD 550 S
CLAY CITY IN 47841

Officer/Director/Trustee Four

ANDREW WHITTINGTON
1ST YEAR DIRECTOR
14350 DENMARK ROAD
COAL CITY IN 47427

Officer/Director/Trustee Five

LARRY LEDGERWOOD
2ND YEAR DIRECTOR
240 PLEASANT VIEW ROAD
COAL CITY IN 47427

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/28/61
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code M24 - Fire Prevention, Protection, Control
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 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 KEITH GRASSICK
Signature Title PRESIDENT
Signature Date 9/30/19

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