FORM 1023-EZ for JUST-A-CHANCE

Field Data
EIN 47-2874614
Case Number EO-2016130-000189
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name JUST-A-CHANCE
Organization’s Mailing Address 243 EAST 16TH ST
City HOLLAND
State MI
ZIP 49423-4212
Accounting period End 1
Primary contact name RONALD CHAVEZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

RONALD CHAVEZ
PRESIDENT
243 EAST 16TH ST
HOLLAND MI 49423-4212

Officer/Director/Trustee Two

JAMES CHIODO
VICE PRESIDENT
2199 WHISPERING DUNES DR
HOLLAND MI 49424-2381

Officer/Director/Trustee Three

JULIE VRUGGINK
TREASURER
4644 PORT SHELDON ST
HUDSONVILLE MI 49426-7808

Officer/Director/Trustee Four

NATHAN SILVA
SECRETARY
4788 142ND AVE
HOLLAND MI 49423-9518

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/19/2015
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
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 Yes
Donation of funds No
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More Yes
Gaming Activity Yes
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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