FORM 1023-EZ for LAKE FENTON MUSIC BOOSTERS

Field Data
EIN 47-4797880
Case Number EO-2015259-000260
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LAKE FENTON MUSIC BOOSTERS
Organization’s Mailing Address 4070 LAHRING ROAD
City LINDEN
State MI
ZIP 48451
Accounting period End 6
Primary contact name THOMAS BROECKER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

TARI PETHICK
PRESIDENT
1090 E BALDWIN ROAD
GRAND BLANC MI 48439

Officer/Director/Trustee Two

REBECCA DUNCAN
VICE-PRESIDENT
10205 BEERS ROAD
SWARTZ CREEK MI 48473

Officer/Director/Trustee Three

THOMAS BROECKER
TREASURER
1451 ST LAWRENCE COURT
FENTON MI 48430-1245

Officer/Director/Trustee Four

HEATHER DOSTIE
SECRETARY
1279 NATALIE DRIVE
FENTON MI 48430

Organization’s website WWW.LAKEFENTONBANDS.COM
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/12/2015
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A6C - Music Groups, Bands, Ensembles
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
Signature Title
Signature Date

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