FORM 1023-EZ for MICHIGAN YOUTH FOR CHILDRENS HEALTH

Field Data
EIN 83-1157074
Case Number EO-2019031-000713
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MICHIGAN YOUTH FOR CHILDRENS HEALTH
Organization’s Mailing Address 45177 DUNBARTON DRIVE
City NOVI
State MI
ZIP 48375
Accounting period End 7
Primary contact name MICHAEL LEAVITT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MICHAEL LEAVITT
DIRECTOR
45177 DUNBARTON DRIVE
NOVI MI 48375

Officer/Director/Trustee Two

BENJAMIN LEAVITT
DIRECTOR
45177 DUNBARTON DRIVE
NOVI MI 48375

Officer/Director/Trustee Three

JASMIN QONJA
DIRECTOR
22270 WATERLAND DRIVE
NORTHVILLE MI 48167

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/7/18
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E12 - 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 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 MICHAEL LEAVITT
Signature Title DIRECTOR
Signature Date 1/5/19

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