FORM 1023-EZ for GRACEWAY CHAPLAIN CARE

Field Data
EIN 47-5111354
Case Number EO-2015348-000425
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name GRACEWAY CHAPLAIN CARE
Organization’s Mailing Address 68509 WINGATE DRIVE
City WASHINGTON
State MI
ZIP 48095-1257
Accounting period End 12
Primary contact name D WAYNE VAN SICKLE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MARK MELILLO
PRESIDENT
440 E ST CLAIR ST APT A3
ALMONT MI 48003-8478

Officer/Director/Trustee Two

PAUL HELD
SECRETARY
28745 FORESTVIEW DRIVE
SOUTHFIELD MI 48033

Officer/Director/Trustee Three

D WAYNE VAN SICKLE
TREASURER
6992 HOUGH RD
ALMONT MI 48003-8917

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/22/2015
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X20 - Christian
Organization’s purpose Charitable: No
Religious: Yes
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 Yes
Donation of funds Yes
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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