FORM 1023-EZ for NORTH KENT SAFE WATER INITIATIVE

Field Data
EIN 83-1152931
Case Number EO-2018192-000133
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name NORTH KENT SAFE WATER INITIATIVE
Organization’s Mailing Address 168 LOUIS CAMPAU PROM NW STE 500
City GRAND RAPIDS
State MI
ZIP 49503
Accounting period End 12
Primary contact name CHARLES E DAMON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

EDWARD WELLS
PRESIDENT
3224 RIVERWOODS DRIVE
ROCKFORD MI 49341

Officer/Director/Trustee Two

TODD OLSON
VICE PRESIDENT
751 SUNFISH DRIVE NE
ROCKFORD MI 49341

Officer/Director/Trustee Three

PAUL DAMON
SECRETARY TREASURER
168 LOUIS CAMPAU PROM NW ST 500
GRAND RAPIDS MI 49503

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/28/18
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code C12 - Fund Raising and/or Fund Distribution
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 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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name EDWARD WELLS
Signature Title PRESIDENT
Signature Date 7/9/18

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