FORM 1023-EZ for CHAZAQ MOVEMENT

Field Data
EIN 81-4311409
Case Number EO-2016309-000255
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CHAZAQ MOVEMENT
Organization’s Mailing Address 300 LACKIE CT
City SANFORD
State MI
ZIP 48657
Accounting period End 3
Primary contact name NICOLLE ATKINSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

REBECCA VANTIFFLIN
OFFICER
4819 DOREY DR
BAY CITY MI 48706

Officer/Director/Trustee Two

KEITH GRABILL
OFFICER
1909 CANDLESTICK LANE
MIDLAND MI 48642

Officer/Director/Trustee Three

AYO AKINDONA
OFFICER
2501 E ASHMAN
MIDLAND MI 48642-4048

Officer/Director/Trustee Four

JULIE ANKLAM
OFFICER
1296 S FAWN CT
SANFORD MI 48657

Officer/Director/Trustee Five

NICOLLE ATKINSON
DIRECTOR
300 LACKIE CT
SANFORD MI 48657

Organization’s website CHAZAQMOVEMENT.COM
Organization’s email NATKINSON@CHAZAQMOVEMENT.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/30/2015
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P73 - Group Home (Long Term)
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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