FORM 1023-EZ for LES CLAY

Field Data
EIN 84-3739187
Case Number EO-2020122-000102
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LES CLAY
Organization’s Mailing Address 1312 JEFFERSON AVE SE
City GRAND RAPIDS
State MI
ZIP 49507
Accounting period End 12
Primary contact name JUDITH LUSAMBA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JUDITH LUSAMBA
CHAIRMAN OF THE BOARD
1312 JEFFERSON AVE SE
GRAND RAPIDS MI 49507

Officer/Director/Trustee Two

GRACE LUSAMBA
CHIEF EXECUTIVE OFFICER
1312 JEFFERSON AVE SE
GRAND RAPIDS MI 49507

Officer/Director/Trustee Three

JIJI LUSAMBA
TREASURER
1312 JEFFERSON AVE SE
GRAND RAPIDS MI 49507

Officer/Director/Trustee Four

MEGHAN COCHRAN
SECRETARY
915 CALVIN AVE SE
GRAND RAPIDS MI 49506

Officer/Director/Trustee Five

REBECCA MUBIYAYI
BOARD MEMBER
1312 JEFFERSON AVE SE
GRAND RAPIDS MI 49507

Organization’s website
Organization’s email LESCLAYSINGERS@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/21/2019
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A20 - Arts, Cultural Organizations - Multipurpose
Organization’s purpose Charitable: No
Religious: Yes
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 Yes
Donation of funds Yes
Conducting Activities Outside of United States Yes
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 JUDITH LUSAMBA
Signature Title CHAIRMAN OF THE BOARD
Signature Date 4/29/2020

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