FORM 1023-EZ for THREE FIRES LOCAL LONGHOUSE

Field Data
EIN 47-5078568
Case Number EO-2016347-000190
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name THREE FIRES LOCAL LONGHOUSE
Organization’s Mailing Address 2874 QUAIL RUN DRIVE
City TROY
State MI
ZIP 48098
Accounting period End 6
Primary contact name BRIAN BASTIEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOSEPH SMITH
PRESIDENT
2874 QUAIL RUN DR
TROY MI 48098

Officer/Director/Trustee Two

SCOTT KOLARCHICK
VICE PRESIDENT
2535 TARRAGONA WAY
TROY MI 48098

Officer/Director/Trustee Three

BRIAN BASTIEN
TREASURER
2893 ORCHARD TRAIL DR
TROY MI 48098

Officer/Director/Trustee Four

WADE TENNANT
SECRETARY
2918 STRAWBERRY DR
TROY MI 48098

Organization’s website WWW.3FIRES.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/25/2015
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
Organization’s purpose Charitable: No
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 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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