FORM 1023-EZ for PORTAGE NORTHERN MENS LACROSSE BOOSTERS INC

Field Data
EIN 47-5441750
Case Number EO-2015338-000346
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PORTAGE NORTHERN MENS LACROSSE BOOSTERS INC
Organization’s Mailing Address 5589 THUNDER BAY
City PORTAGE
State MI
ZIP 49024
Accounting period End 6
Primary contact name JEANETTE L SOWELL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JEANETTE SOWELL
PRESIDENT
1411 FRIENDLY AVENUE
PORTAGE MI 49002

Officer/Director/Trustee Two

JAY VAN BUSKIRK
TREASURER
4623 BRIARHILL DRIVE
PORTAGE MI 49024

Officer/Director/Trustee Three

KIP WALTKE
VICE PRESIDENT
5589 THUNDER BAY
PORTAGE MI 49024

Officer/Director/Trustee Four

BARBARA LEONE
SECRETARY
5427 GATWICK COURT
KALAMAZOO MI 49009

Officer/Director/Trustee Five

JULIA SEIFERLEIN
DIRECTOR
6808 AMBERLY STREET
PORTAGE MI 49024

Organization’s website WWW.PORTAGENORTHERNLACROSSE.COM
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/28/2015
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N50 - Recreational, Pleasure, or Social Club
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 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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