FORM 1023-EZ for HIGHLAND PARK YOUTH ATHLETIC ASSOCIATION INC

Field Data
EIN 82-2102789
Case Number EO-2019063-000579
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HIGHLAND PARK YOUTH ATHLETIC ASSOCIATION INC
Organization’s Mailing Address PO BOX 3457
City HIGHLAND PARK
State MI
ZIP 48203
Accounting period End 12
Primary contact name CARLTON CLYBURN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CARLTON CLYBURN
VICE CHAIR
59 RHODE ISLAND ST
HIGHLAND PARK MI 48203

Officer/Director/Trustee Two

JUSTIN PETTY
CHAIR
66 EASON
HIGHLAND PARK MI 48203

Officer/Director/Trustee Three

GERRAJH SURLES
TREASURER
2001 LONGFELLOW
DETROIT MI 48206

Officer/Director/Trustee Four

GLENN WASHINGTON
DIRECTOR
385 CORTLAND
HIGHLAND PARK MI 48203

Officer/Director/Trustee Five

MARTIN DONALDSON
SECRETARY
11120 ROXBURY
DETROIT MI 48224

Organization’s website WWW.HPYAA.ORG
Organization’s email INFO@HPYAA.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/21/17
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: Yes
Religious: No
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 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 CARLTON CLYBURN
Signature Title VICE CHAIR
Signature Date 3/2/19

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