FORM 1023-EZ for FLY SWIM BOOSTERS INC

Field Data
EIN 82-1674002
Case Number EO-2017234-000188
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name FLY SWIM BOOSTERS INC
Organization’s Mailing Address 8332 OFFICE PARK DRIVE SUITE B
City GRAND BLANC
State MI
ZIP 48439
Accounting period End 12
Primary contact name WILLIAM E DELZER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JASON SIELOFF
DIRECTOR
11515 KINGS KNIGHTS CIRCLE
GRAND BLANC MI 48439

Officer/Director/Trustee Two

DANIEL FRIES
DIRECTOR
134 NORTH LEROY SUITE 208
FENTON MI 48430

Officer/Director/Trustee Three

NICOLE ELMQUIST
DIRECTOR
2484 MISTY LANE
DAVISON MI 48439

Officer/Director/Trustee Four

WILLIAM DELZER
DIRECTOR
6075 WINGED FOOT DRIVE
GRAND BLANC MI 48439

Organization’s website WWW.FLYSWIM.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/13/2017
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N67 - Swimming, Water Recreation
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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