FORM 1023-EZ for CHASIN BIRDIES GOLF CAMP

Field Data
EIN 47-3917181
Case Number EO-2015155-000190
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CHASIN BIRDIES GOLF CAMP
Organization’s Mailing Address 10105 120TH AVE
City WEST OLIVE
State MI
ZIP 49460-9654
Accounting period End 5
Primary contact name CHASE KUYERS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

TOM EAGLE
VOLUNTEER BOARD OFFICER
13823 HOFMA DRIVE
GRAND HAVEN MI 49417-9698

Officer/Director/Trustee Two

BILL QUALLS
VOLUNTEER BOARD OFFICER
3793 LAKE COURT DRIVE
HOLLAND MI 49424-2410

Officer/Director/Trustee Three

JACOB HEYBLOM
VOLUNTEER BOARD OFFICER
1417 MARGARET AVE SE
GRAND RAPIDS MI 49507-2264

Officer/Director/Trustee Four

CARRIE ENGELS
VOLUNTEER BOARD TRUSTEE
134 WASHINGTON AVE
GRAND HAVEN MI 49417-1355

Officer/Director/Trustee Five

CHASE KUYERS
EXECUTIVE DIRECTOR
10105 120TH AVE
WEST OLIVE MI 49460-9654

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/5/2015
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O20 - Youth Centers, Clubs, Multipurpose
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: Yes
Public Safety: No
Amateur Sports: No
Cruelty Prevention: Yes
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 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
Signature Title
Signature Date

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