FORM 1023-EZ for EMBRACE MUSKEGON

Field Data
EIN 27-4010021
Case Number EO-2015288-000002
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name EMBRACE MUSKEGON
Organization’s Mailing Address 1050 W SOUTHERN AVE
City MUSKEGON
State MI
ZIP 49445-2270
Accounting period End 12
Primary contact name WALLY HARRISON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

STAN SIKKENGA
CHAIR
19943 CATHERINE
MUSKEGON MI 49441

Officer/Director/Trustee Two

BETH BOLTHOUSE
VICE CHAIR
3044 WESTLAND RD
MUSKEGON MI 49441

Officer/Director/Trustee Three

HEIDI DECKER
SECRETARY-TREASURER
11529 LAKETON AVE
RAVENNA MI 49451

Officer/Director/Trustee Four

WALLY HARRISON
INTERIM EXECUTIVE DIRECTOR
1415 HILLCREST ST
GRAND HAVEN MI 49417

Organization’s website WWW.EMBRACEMUSKEGON.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/14/2011
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 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
Signature Title
Signature Date

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