FORM 1023-EZ for H LAX INC

Field Data
EIN 47-2540390
Case Number EO-2015127-000475
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name H LAX INC
Organization’s Mailing Address 2714 RENFREW WAY
City LANSING
State MI
ZIP 48911
Accounting period End 6
Primary contact name BILL PETERSEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

BILL PETERSEN
PRESIDENT
2714 RENFREW WAY
LANSING MI 48911

Officer/Director/Trustee Two

LISA AUSEL
VICE PRESIDENT
1872 GALE RD
EATON RAPIDS MI 48827

Officer/Director/Trustee Three

KIM ETHERIDGE
TREASURER
3580 SORORITY LANE
HOLT MI 48842

Officer/Director/Trustee Four

LISA GEMALSKY
SECRETARY
6870 KINGDON AVE
HOLT MI 48842

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/23/2015
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B11 - Single Organization Support
Organization’s purpose Charitable: No
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
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
Signature Title
Signature Date

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