FORM 1023-EZ for DANSVILLE AMBULANCE COMPANY INC

Field Data
EIN 16-1489979
Case Number EO-2017053-000050
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name DANSVILLE AMBULANCE COMPANY INC
Organization’s Mailing Address 18 OSSIAN STREET
City DANSVILLE
State NY
ZIP 14437
Accounting period End 12
Primary contact name JESSICA HARVEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JERRY JACKSON
PRESIDENT
18 COTTAGE ST
DANSVILLE NY 14437

Officer/Director/Trustee Two

HAROLD WOLFE
V PRESIDENT
13 CLINTON ST
DANSVILLE NY 14437

Officer/Director/Trustee Three

TIM BARRETT
DEPUTY TREASURER
13 PARK AVE
DANSVILLE NY 14437

Officer/Director/Trustee Four

JESSICA HARVEY
TRESURER
116 OSSIAN ST
DANSVILLE NY 14437

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/22/1995
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E62 - Ambulance, Emergency Medical Transport Services
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 Yes
One Third Support Public No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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