FORM 1023-EZ for BLACK LAKE PRESERVATION SOCIETY

Field Data
EIN 81-2288033
Case Number EO-2016237-000210
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BLACK LAKE PRESERVATION SOCIETY
Organization’s Mailing Address 2690 WHITE OAK DRIVE
City ANN ARBOR
State MD
ZIP 48103
Accounting period End 12
Primary contact name RUSSELL GOWLAND
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RUSSELL GOWLAND
PRESIDENT
21 BOONE TRAIL
SEVERNA PARK MD 21146

Officer/Director/Trustee Two

STEVEN WILD
VICE PRESIDENT
2690 WHITE OAK DRIVE
ANN ARBOR MI 48103

Officer/Director/Trustee Three

BEVERLY HAAS
SECRETARY
PO BOX 206
VICKSBURG MI 49097

Officer/Director/Trustee Four

LINDA WOODS
TREASURER
3000 VALORIE LANE
MIDLAND MI 48640-2457

Officer/Director/Trustee Five

JAMES CORDES
DIRECTOR
3914 MOREL CT
MIDLAND MI 48642

Organization’s website BLACKLAKEPRESERVATIONSOCIETY.ORG
Organization’s email BLACKLAKEPRESERVATIONSOCIETY@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/26/2016
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code C32 - Water Resource, Wetlands Conservation and Management
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
Signature Title
Signature Date

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