FORM 1023-EZ for MATTAWAN ROBOTICS

Field Data
EIN 47-5105173
Case Number EO-2019227-000098
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MATTAWAN ROBOTICS
Organization’s Mailing Address 49470 MEADOW OAK TRAIL
City MATTAWAN
State MI
ZIP 49071
Accounting period End 12
Primary contact name JOHN HULSEBUS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOHN HULSEBUS
PRESIDENT
49470 MEADOW OAK TRAIL
MATTAWAN MI 49071

Officer/Director/Trustee Two

JOHN CROSS
VICE PRESEIDENT
626 SILVA STREET
KALAMAZOO MI 49009

Officer/Director/Trustee Three

OLGA HULSEBUS
SECRETARY
49470 MEADOW OAK TRAIL
MATTAWAN MA 49071

Organization’s website HTTP://MATTAWAN-ROBOTICS.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/14/16
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
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 No
One Third Support Public Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name JOHN HULSEBUS
Signature Title PRESIDENT
Signature Date 8/13/19
EIN 47-5105173
Case Number EO-2016223-000071
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MATTAWAN ROBOTICS
Organization’s Mailing Address 49470 MEADOW OAK TRAIL
City MATTAWAN
State MI
ZIP 49071
Accounting period End 12
Primary contact name JOHN HULSEBUS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOHN HULSEBUS
PRESIDENT
49470 MEADOW OAK TRAIL
MATTAWAN MI 49071

Officer/Director/Trustee Two

STACI ESCH
VICE PRESIDENT
10980 RIEDELL DR
KALAMAZOO MI 49009

Officer/Director/Trustee Three

JOHN CROSS
ENGINEERING DIRECTOR
626 SILVA STREET
KALAMAZOO MI 49009

Officer/Director/Trustee Four

OLGA HULSEBUS
SECRETARY
49470 MEADOW OAK TRAIL
MATTAWAN MI 49071

Officer/Director/Trustee Five

RUSSELL GORTER
SPONSORSHIP DIRECTOR
1440 E CROOKED LAKE DR
KALAMAZOO MI 49009

Organization’s website HTTP://ROBOKATS.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/14/2016
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
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 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
Signature Title
Signature Date

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