FORM 1023-EZ for HORNETS HOMESCHOOL BASKETBALL ASSOCIATION

Field Data
EIN 47-5067393
Case Number EO-2015264-000362
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HORNETS HOMESCHOOL BASKETBALL ASSOCIATION
Organization’s Mailing Address 7152 KNAPP NE
City ADA
State MI
ZIP 49301-8364
Accounting period End 5
Primary contact name JOEL BROERSMA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

TAMMY HOLSTEGE
BOARD OF DIRECTORS PRESIDENT
7152 KNAPP NE
ADA MI 49301-8364

Officer/Director/Trustee Two

TIM DEVRIES
BOARD OF DIRECTORS VICE-PRES
7152 KNAPP NE
ADA MI 49301-8364

Officer/Director/Trustee Three

JOEL BROERSMA
BOARD OF DIRECTORS TREASURER
7152 KNAPP NE
ADA MI 49301-8364

Officer/Director/Trustee Four

DENISE KERKSTRA
BOARD OF DIRECTORS SECRETARY
7152 KNAPP NE
ADA MI 49301-8364

Officer/Director/Trustee Five

LEE DALRYMPLE
BOARD OF DIRECTORS
7152 KNAPP NE
ADA MI 49301-8364

Organization’s website HUDSONVILLEHORNETS1.TEAMOPOLIS.COM
Organization’s email HUDSONVILLEHORNETS@GMAIL.COM
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 N62 - Basketball
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 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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