FORM 1023-EZ for PORTAGE NORTHERN CROSS COUNTRY BOOSTERS

Field Data
EIN 47-4517005
Case Number EO-2015208-000206
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PORTAGE NORTHERN CROSS COUNTRY BOOSTERS
Organization’s Mailing Address 2401 WEST CENTRE AVE
City PORTAGE
State MI
ZIP 49024-4823
Accounting period End 12
Primary contact name DANIEL J GAVLAS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DANIEL GAVLAS
TREASURER
2401 WEST CENTRE
PORTAGE MI 49024-4034

Officer/Director/Trustee Two

BRIAN VANDERHOFF
PRESIDENT
5752 WINDSCAPE DR
KALAMAZOO MI 49009-5939

Officer/Director/Trustee Three

DIANE HAMLIN
SECRETARTY
7143 CROWN POINTE CIRCLE
PORTAGE MI 49024-4038

Officer/Director/Trustee Four

ANNETTE DANIEL
DIRECTOR
2888 PFITZER AVENUE
PORTAGE MI 49024-2398

Officer/Director/Trustee Five

ROBYN LEWIS
DIRECTOR
8343 PHOEBE
KALAMAZOO MI 49009-4510

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/10/2015
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N01 - Alliance/Advocacy Organizations
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 Yes
One Third Support Gifts No
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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