FORM 1023-EZ for HARBOR COUNTRY COMMUNITIES FOR A LIFETIME

Field Data
EIN 46-5736445
Case Number EO-2015083-000029
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HARBOR COUNTRY COMMUNITIES FOR A LIFETIME
Organization’s Mailing Address 1221 SHORE DRIVE
City NEW BUFFALO
State MI
ZIP 49117-2008
Accounting period End 12
Primary contact name HILLARY BUBB
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

HILLARY BUBB
CHAIR
1221 SHORE DRIVE
NEW BUFFALO MI 49117-2008

Officer/Director/Trustee Two

TOM HACKLEY
VICE-CHAIR
7270 HOME AVENUE
HARBERT MI 49115-5133

Officer/Director/Trustee Three

ADAM UMBRASAS
SECRETARY
14 MAPLE STREET
THREE OAKS MI 49128-1131

Officer/Director/Trustee Four

RICH KOCHANNY
TREASURER
6130 BROWNTOWN
SAWYER MI 49125-9144

Officer/Director/Trustee Five

JOANNE SIMS
AT-LARGE MEMBER
14660 MEADOW LANE
LAKESIDE MI 49116-5133

Organization’s website
Organization’s email HILLBUBB@COMCAST.NET
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/25/2014
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P80 - Services to Promote the Independence of Specific Populations
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
Signature Title
Signature Date

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