FORM 1023-EZ for LAKE MICHIGAN POLICE CANINE ASSOCIATION

Field Data
EIN 86-2018366
Case Number EO-2021099-000990
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LAKE MICHIGAN POLICE CANINE ASSOCIATION
Organization’s Mailing Address 820 CONGER STREET
City SOUTH HAVEN
State MI
ZIP 49090
Accounting period End 12
Primary contact name NICOLE BURNSIDE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CHRISTOPHER MERSMAN
PRESIDENT
4264 125TH AVE
ALLEGAN MI 49010

Officer/Director/Trustee Two

ERIC CALHOUN
VICE PRESIDENT
50118 CR 388
GRAND JUNCTION MI 49056

Officer/Director/Trustee Three

KEVIN VANBRUSSEL
SECRETARY
820 CONGER STREET
SOUTH HAVEN MI 49090

Officer/Director/Trustee Four

CONSTANCE ROBERTS
TREASURER
3421 S DYE ROAD
FLINT MI 48507

Officer/Director/Trustee Five

NATALIE THOMPSON
DIRECTOR
75746 14TH AVE
SOUTH HAVEN MI 49090

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/8/2021
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W12 - Fund Raising and/or Fund Distribution
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 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 KEVIN VANBRUSSEL
Signature Title SECRETARY
Signature Date 3/18/2021

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