FORM 1023-EZ for OUT ON THE LAKESHORE

Field Data
EIN 81-3619194
Case Number EO-2016242-000127
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name OUT ON THE LAKESHORE
Organization’s Mailing Address PO BOX 1542
City HOLLAND
State MI
ZIP 49422
Accounting period End 12
Primary contact name CHARLEY BOWERS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DANIEL FIRMAN
CHAIRMAN
4950 32ND AVE
HUDSONVILLE MI 49426

Officer/Director/Trustee Two

KIMBERLY KOWTOW SKI
VICE CHAIRMAN
379 CHIPPEWA DR
HOLLAND MI 49424

Officer/Director/Trustee Three

JAMES CECH
TREASURER
2568 104TH AVE
ZEELAND MI 49464

Officer/Director/Trustee Four

KAREN PRINS
SECRETARY
19 OLD MILL DR UNIT 13
HOLLAND MI 49423

Officer/Director/Trustee Five

CHARLEY BOWERS
BOARD MEMBER LEGAL AFFAIRS
57207 COUNTY RD 380
GRAND JUNCTION MI 49056

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/12/2016
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code R26 - Lesbian, Gay Rights
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 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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