FORM 1023-EZ for BLUES GYM
| Field | Data |
|---|---|
| EIN | 47-2405972 |
| Case Number | EO-2015082-000432 |
| Form 1023-EZ version | 62014 |
| Eligibility Worksheet | 1 |
| Organization Name | BLUES GYM |
| Organization’s Mailing Address | 4248 KALAMAZOO AVENUE SUITE B |
| City | GRAND RAPIDS |
| State | MI |
| ZIP | 49508 |
| Accounting period End | 12 |
| Primary contact name | GARRETT J TENHAVE-CHAPMAN |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $400.00 |
Officer/Director/Trustee One
GARRETT TENHAVE-CHAPMAN
CHAIR
4248 KALAMAZOO AVE SE SUITE B
GRAND RAPIDS MI 49508
Officer/Director/Trustee Two
DEREK LADO
VICE CHAIR
3351 EAGLE RUN DRIVE
GRAND RAPIDS MI 49525
Officer/Director/Trustee Three
CHARLES PIPPIN
TREASURER
857 MARCIA STREET SW
WYOMING MI 49509
Officer/Director/Trustee Four
OSWALDO ORTIZ
DIRECTOR
40 CALHOUN STREET SW
GRAND RAPIDS MI 49548
Officer/Director/Trustee Five
DEAN NEWVILLE
DIRECTOR
2290 28TH STREET SW
WYOMING MI 49519
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 11/6/2014 |
| Organization Incorporation State | MI |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | N40 - Sports Training Facilities, Agencies |
| Organization’s purpose | Charitable: Yes 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 | No |
| Financial transactions with officers | No |
| Unrelated Gross Income $1,000 or More | Yes |
| 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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