FORM 1023-EZ for THE ALAN WALLACE YOUTH SPORTS FOUNDATION

Field Data
EIN 85-3556797
Case Number EO-2021252-000304
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name THE ALAN WALLACE YOUTH SPORTS FOUNDATION
Organization’s Mailing Address 12110 SCOTCH HOLLOW DR
City BATH
State MI
ZIP 48808
Accounting period End 12
Primary contact name STACY WALLACE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

STACY WALLACE
TREASURER
ONE MICHIGAN AVENUE SUITE 900
LANSING MI 48933

Officer/Director/Trustee Two

SCOTT ELDRIDGE
DIRECTOR
ONE MICHIGAN AVENUE SUITE 900
LANSING MI 48933

Officer/Director/Trustee Three

DALE HOSFORD
SECRETARY
12110 SCOTCH HOLLOW DR
BATH MI 48808

Officer/Director/Trustee Four

LARRY KLUSACK
PRESIDENT
12110 SCOTCH HOLLOW DR
BATH MI 48808

Officer/Director/Trustee Five

SAMUEL PARKS
AUTHORIZED REP
840 WEST LONG LAKE ROAD SUITE 150
TROY MI 48098

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/1/2020
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 Yes
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 SAMUEL PARKS
Signature Title AUTHORIZED REP
Signature Date 9/7/2021

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