FORM 1023-EZ for PLANT BASED ROOTS

Field Data
EIN 82-1921265
Case Number EO-2017207-000061
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PLANT BASED ROOTS
Organization’s Mailing Address 100 10 MILE RD NW
City SPARTA
State MI
ZIP 49345
Accounting period End 12
Primary contact name KIM ENOCHS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ERICA WISNIEWSKI
PRESIDENT
9327 CLEAR MEADOW DR SE
ADA MI 49301

Officer/Director/Trustee Two

KYUNGHEE ENOCHS
VICE PRESIDENT, TREASURER
100 10 MILE RD NW
SPARTA MI 49345

Officer/Director/Trustee Three

MARK MICHON
FINANCE DIRECTOR
4893 N QUAIL CREST DR SE
GRAND RAPIDS MI 49546

Officer/Director/Trustee Four

KRISTINE MILLER
MARKETING DIRECTOR
633 W GRGER ST
HASTINS MI 49508

Officer/Director/Trustee Five

CHERYL STILL
SECRETARY
4053 WOODLAND CREEK DR SE
KENTWOOD MI 49512

Organization’s website WWW.PLANTBASEDROOTS.ORG
Organization’s email GRVEGFEST@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/9/2017
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code K40 - Nutrition Programs
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 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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