FORM 1023-EZ for MICHIGAN CLINICIANS FOR CLIMATE ACTION

Field Data
EIN 85-3050301
Case Number EO-2021065-000049
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MICHIGAN CLINICIANS FOR CLIMATE ACTION
Organization’s Mailing Address 10404 SOUTH WESTERN HILLS DRIVE
City TRAVERSE CITY
State MI
ZIP 49684-6897
Accounting period End 12
Primary contact name JULIE QUINN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JULIE QUINN
PROJECT MANAGER; TREASURER
10404 SOUTH WESTERN HILLS DRIVE
TRAVERSE CITY MI 49684

Officer/Director/Trustee Two

LISA DELBUONO
EXECUTIVE DIRECTOR ; PRESIDENT
1800 NELSON ROAD
TRAVERSE CITY MI 49686

Officer/Director/Trustee Three

LARRY JUNCK
BOARD MEMBER
3588 PLYMOUTH ROAD 221
ANN ARBOR MI 48105

Organization’s website STATES.MS2CH.ORG
Organization’s email MIC4CA@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/19/2000
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code C01 - Alliance/Advocacy Organizations
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence Yes
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 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 JULIE QUINN
Signature Title PROJECT MANAGER; TREASURER
Signature Date 1/15/2021

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