FORM 1023-EZ for LIGHT AT THE INN

Field Data
EIN 81-3511512
Case Number EO-2020034-000258
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LIGHT AT THE INN
Organization’s Mailing Address 120 O DILL DRIVE
City NORWAY
State MI
ZIP 49870
Accounting period End 8
Primary contact name SANDRDA MEIER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BONNIE PELTO
CHAIRPERSON
W6100 M95
IRON MOUNTAIN MI

Officer/Director/Trustee Two

JAY GOUDREAU
VICE CHAIRPERSON
1200 GRANT
NIAGARA WI 54151

Officer/Director/Trustee Three

SANDRA MEIER
TREASURER
W8105 S LAKE ANTOINE
IRON MOUNTAIN MI

Officer/Director/Trustee Four

YVONNE CLARK
SECRETARY
235 W GRANT ST
IRON MOUNTAIN MI

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/23/2016
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code L41 - Homeless, Temporary Shelter For
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name JAY GOUDREAU
Signature Title VICE CHAIRPERSON
Signature Date 1/30/2020
EIN 81-3511512
Case Number EO-2016244-000325
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LIGHT AT THE INN
Organization’s Mailing Address 120 O DILL DRIVE
City NORWAY
State MI
ZIP 49870
Accounting period End 8
Primary contact name SANDRA MEIER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

GERI HAMLEN
CHAIRPERSON
421 WOODWARD AVE
KINGSFORD MI 49802-4630

Officer/Director/Trustee Two

CINDI STREHLOW
VICE CHAIRPERSON
225 E SAGOLA AVE
KINGSFORD MI 49802

Officer/Director/Trustee Three

YVONNE CLARK
SECRETARY
235 W GRANT ST
IRON MOUNTAIN MI 49801

Officer/Director/Trustee Four

PAM SMART
TREASURER
N22663 ANTONISSED RD
NIAGARA WI 54151

Officer/Director/Trustee Five

IRENE WHITE
AT LARGE
725 NORWAY ST
NORWAY MI 49870

Organization’s website WWW.LIGHTATTHEINN.COM
Organization’s email LIGHTATTHEINN@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/23/2016
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code L41 - Homeless, Temporary Shelter For
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 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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