FORM 1023-EZ for SOUTH HAVEN SURGE

Field Data
EIN 83-4447003
Case Number EO-2019154-000356
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SOUTH HAVEN SURGE
Organization’s Mailing Address 74899 12TH AVENUE
City SOUTH HAVEN
State MI
ZIP 49090
Accounting period End 12
Primary contact name KAILEIGH C EDDY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KAILEIGH EDDY
VICE PRESIDENT
74899 12TH AVENUE
SOUTH HAVEN MI 49090

Officer/Director/Trustee Two

TROY AYOTTE
PRESIDENT
535 BAILEY AVENUE
SOUTH HAVEN MI 49090

Officer/Director/Trustee Three

ROBERT HAYES
SECRETARY
75222 12TH AVENUE
SOUTH HAVEN MI 49090

Officer/Director/Trustee Four

KERRI HAYES
TREASURER
75222 12TH AVENUE
SOUTH HAVEN MI 49090

Officer/Director/Trustee Five

ELIZABETH AYOTTE
DIRECTOR
535 BAILEY AVENUE
SOUTH HAVEN MI 49090

Organization’s website
Organization’s email SOHASURGE@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/13/19
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N60 - Amateur Sports Clubs, Leagues, N.E.C.
Organization’s purpose Charitable: No
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 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 KAILEIGH EDDY
Signature Title VICE PRESIDENT
Signature Date 5/31/19

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