FORM 1023-EZ for CHRISTIAN SOCIETY FOR KINESIOLOGY AND LEISURE STUDIES

Field Data
EIN 26-0082829
Case Number EO-2014241-000227
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CHRISTIAN SOCIETY FOR KINESIOLOGY AND LEISURE STUDIES
Organization’s Mailing Address 5272 BURGIS AVENUE SE
City KENTWOOD
State MI
ZIP 49508-6038
Accounting period End 5
Primary contact name GLEN VAN ANDEL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

TOM VISKER
PRESIDENT
100 BETHEL CIRCLE
MISHAWAKA MI 46545

Officer/Director/Trustee Two

MATTHEW RUIZ
PRESIDENT-ELECT
2303 COLLEGE AVENUE
HUNTINGTON IN 46750

Officer/Director/Trustee Three

GLEN VAN ANDEL
SECRETARY TREASURER
5272 BURGIS AVENUE SE
Kentwood MI 49508-6038

Officer/Director/Trustee Four

DALE CONNALLY
DIRECTOR-AT-LARGE
ONE BEAR PLACE - 97313
WACO TX 76798-7371

Officer/Director/Trustee Five

WAYNE JACOBS
DIRECTOR-AT-LARGE
P O BOX 7001
LONGVIEW TX 75607-7001

Organization’s website CSKLS.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/26/2002
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Y03 - Professional Societies, Associations
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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