FORM 1023-EZ for AS-IF ADAPTIVE SPORTS INSPIRED FOREVER

Field Data
EIN 47-0967132
Case Number EO-2015239-000197
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name AS-IF ADAPTIVE SPORTS INSPIRED FOREVER
Organization’s Mailing Address 4728 WOLF RUN AVE SE
City KENTWOOD
State MI
ZIP 49548
Accounting period End 12
Primary contact name CHARLES BENNETT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

SANDRA BLACKWELL
PRESIDENT
4728 WOLF RUN AVE SE
KENTWOOD MI 49548

Officer/Director/Trustee Two

ESTELLE SLOOTMAKER
SECRETARY
1501 MAPLELAWN
WYOMING MI 49509

Officer/Director/Trustee Three

CHARLES BENNETT
TREASURER
324 NATIONAL AVE NW
GRAND RAPIDS MI 49504

Officer/Director/Trustee Four

NICK GENTRY
TRUSTEE
1531 PRINCETON RD
MUSKEGON MI 49441

Officer/Director/Trustee Five

MARYJO GENTRY
TRUSTEE
1531 PRINCETON RD
MUSKEGON MI 49441

Organization’s website WWW.AS-IFABLE.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/5/2014
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N12 - Fund Raising and/or Fund Distribution
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
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 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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