FORM 1023-EZ for SPECIAL YOUTH OUTREACH

Field Data
EIN 81-1305452
Case Number EO-2016081-000148
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SPECIAL YOUTH OUTREACH
Organization’s Mailing Address 3909 MICHIGAN UNION
City ANN ARBOR
State MI
ZIP 48109
Accounting period End 5
Primary contact name 973-830-9530
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ROBERT SCHWARTZ
PRESIDENT
200 PACKARD STREET
ANN ARBOR MI 48104

Officer/Director/Trustee Two

CONNOR WILLIAMS
SECRETARY
200 PACKARD STREET
ANN ARBOR MI 48104

Officer/Director/Trustee Three

KYLE WILLIAMS
INCORPORATOR
24034 ELIZABETH LANE
NOVI MI 48374

Officer/Director/Trustee Four

DAVIS VORVA
VICE PRESIDENT
2126 PAULINE BLVD
ANN ARBOR MI 48103

Officer/Director/Trustee Five

THOMAS JOHNSON
CO-FOUNDER
200 PACKARD STREET
ANN ARBOR MI 48104

Organization’s website
Organization’s email SPECIALYOUTHOUTREACH@UMICH.EDU
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/30/2015
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N99 - Recreation, Sports, Leisure, Athletics N.E.C.
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
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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