FORM 1023-EZ for LAKEWOOD WRESTLING CLUB

Field Data
EIN 38-2401887
Case Number EO-2016160-000281
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LAKEWOOD WRESTLING CLUB
Organization’s Mailing Address 6328 LAKESORE DR
City SARANAC
State MI
ZIP 48881-8789
Accounting period End 5
Primary contact name TIM GIRVIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ROBERT VEITCH
PRESIDENT
11376 TASKER RD
LAKE ODESSA MI 48849

Officer/Director/Trustee Two

JAN JACKSON
SECRETARY
3003 DURKEE RD
LAKE ODESSA MI 48849

Officer/Director/Trustee Three

TIM GIRVIN
TREASURER / RESIDENT AGENT
6328 LAKESHORE DR
SARANAC MI 48881

Officer/Director/Trustee Four

BRAD BENNETT
VICE PRESIDENT
1966 E CLARKSVILLE RD
PORTLAND MI 48875

Officer/Director/Trustee Five

JEFF MAAG
DIRECTOR
4293 GRAND LEDGE HWY
MULLIKEN MI 48861

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/8/1987
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N60 - Amateur Sports Clubs, Leagues, N.E.C.
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 Yes
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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