FORM 1023-EZ for STEVENSON FAMILY MEMORIAL

Field Data
EIN 83-4530873
Case Number EO-2019119-000092
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name STEVENSON FAMILY MEMORIAL
Organization’s Mailing Address 1122 FIGG
City FRANKFORT
State MI
ZIP 49635
Accounting period End 12
Primary contact name BRENNA MARIE DILTS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BRENNA DILTS
OFFICER
1122 FIGG
FRANKFORT MI 49635

Officer/Director/Trustee Two

TYLER STEVENSON
OFFICER
2931 DEBORAH LANE
FRANKFORT MI 49635

Officer/Director/Trustee Three

ASHLEE STEVENSON
OFFICER
27660 TRACY ROAD
WALBRIDGE OH 43465-9742

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/1/19
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A12 - Fund Raising and/or Fund Distribution
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 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 No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name BRENNA DILTS
Signature Title OFFICER
Signature Date 4/25/19

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