FORM 1023-EZ for LAKE COUNTY SPORTSMANS CLUB

Field Data
EIN 90-0798121
Case Number EO-2016048-000280
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LAKE COUNTY SPORTSMANS CLUB
Organization’s Mailing Address PO BOX 303
City BALDWIN
State MI
ZIP 49304-8971
Accounting period End 12
Primary contact name JOHN BEACH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

GREG NICHOLS
PRESIDENT
PO BOX 303
BALDWIN MI 49304-8971

Officer/Director/Trustee Two

CHUCK UHLMAN
VICE PRESIDENT
3661 N MERRILLVILLE RD
LUTHER MI 49656

Officer/Director/Trustee Three

JOHN BEACH
SECRETARY/TREASURER
8597 W DEER RUN
BALDWIN MI 49304-8971

Officer/Director/Trustee Four

HAROLD NICHOLS
TRUSTEE
700 NORWAY RD
BALDWIN MI 49304-8971

Officer/Director/Trustee Five

CLINT JACKSON
TRUSTEE
PO BOX 816
BALDWIN MI 49304-8971

Organization’s website WWW.LAKECOUNTYSPORTSMANSCLUB.COM
Organization’s email LCSC0211@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/19/2011
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N61 - Fishing, Hunting Clubs
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 Yes
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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