FORM 1023-EZ for JACOB BROWNE MEMORIAL PARK

Field Data
EIN 81-3273186
Case Number EO-2016224-000545
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name JACOB BROWNE MEMORIAL PARK
Organization’s Mailing Address 25564 MAYWOOD STREET
City WOODHAVEN
State MI
ZIP 48183
Accounting period End 12
Primary contact name JENNIFER BROWNE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JENNIFER BROWNE
OFFICER
25564 MAYWOOD STREET
WOODHAVEN MI 48183

Officer/Director/Trustee Two

AMEE RAVETTO
OFFICER
12949 PULLMAN
SOUTHGATE MI 48195

Officer/Director/Trustee Three

TRACEY NAGY
OFFICER
34691 WEST JEFFERSON
ROCKWOOD MI 48173

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/19/2016
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S20 - Community, Neighborhood Development, Improvement (General)
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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