FORM 1023-EZ for BERISTA INC

Field Data
EIN 86-3748383
Case Number EO-2021132-000297
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BERISTA INC
Organization’s Mailing Address 215 WASHINGTON
City GRAND HAVEN
State MI
ZIP 49417
Accounting period End 12
Primary contact name ERIN LYON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ERIN LYON
PRESIDENT
1125 PENNOYER AVE
GRAND HAVEN MI 49417

Officer/Director/Trustee Two

LINDSAY HARTMAN
TREASURER
1005 COLUMBUS AVE
GRAND HAVEN MI 49417

Officer/Director/Trustee Three

ROSETTA DUNLAP
SECRETARY
17678 ALLEN AVE
SPRING LAKE MI 49456

Organization’s website
Organization’s email KENZIESBECAFE@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/6/2021
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code J99 - Employment, Job Related N.E.C.
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 Yes
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 ERIN LYON
Signature Title PRESIDENT
Signature Date 5/10/2021

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