FORM 1023-EZ for VINEYARD VILLAGE

Field Data
EIN 83-2864228
Case Number EO-2019029-000736
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name VINEYARD VILLAGE
Organization’s Mailing Address 11581 MCFALL DRIVE
City WILLIS
State MI
ZIP 48191
Accounting period End 12
Primary contact name PAULA HOLTZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PAULA HOLTZ
PRESIDENT
11581 MCFALL DR
WILLIS MI 48191

Officer/Director/Trustee Two

VIC HOLTZ
SECRETARY
11581 MCFALL DR
WILLIS MI 48191

Officer/Director/Trustee Three

PETER BURKIT
TREASURER
6978 LAKESHORE DR
NEWPORT MI 48166

Officer/Director/Trustee Four

MADONNA BURKIT
DIRECTOR
6978 LAKESHORE DR
NEWPORT MI 48166

Officer/Director/Trustee Five

TY GUTHRIE
DIRECTOR
15427 KEEGAN
MONROE MI 48161

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/18/18
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code J21 - Vocational Counseling, Guidance and Testing
Organization’s purpose Charitable: Yes
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 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 PAULA HOLTZ
Signature Title PRESIDENT
Signature Date 12/18/18

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