FORM 1023-EZ for ELLCLAIR COMMITTEE

Field Data
EIN 82-3041511
Case Number EO-2018019-000364
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ELLCLAIR COMMITTEE
Organization’s Mailing Address 10595 SKYLINE DRIVE
City ELLSWORTH
State MI
ZIP 49729
Accounting period End 12
Primary contact name DAVID RASMUSSEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DAVID RASMUSSEN
PRESIDENT
10595 SKYLINE DRIVE
ELLSWORTH MI 49729

Officer/Director/Trustee Two

CHUCK FOX
VICE PRESIDENT
9909 US 31
ELLSWORTH MI 49729

Officer/Director/Trustee Three

JAN RASMUSSEN
SECRETARY/TREASURER
9660 LAKE STREET
ELLSWORTH MI 49729

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/1/17
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W24 - Citizen Participation
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name DAVID RASMUSSEN
Signature Title PRESIDENT
Signature Date 1/17/18

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