FORM 1023-EZ for THE C CLUB INCORPORATED

Field Data
EIN 83-4376638
Case Number EO-2019157-000416
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name THE C CLUB INCORPORATED
Organization’s Mailing Address 35100 LITTLE MACK AVENUE
City CLINTON
State MI
ZIP 48035-2633
Accounting period End 12
Primary contact name BARRY R POWERS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

GERALD BLAZIUS
DIRECTOR, CHAIR, PRESIDENT
47252 GRAND CYPRESS COURT
MACOMB MI 48044-3025

Officer/Director/Trustee Two

SCOTT LESHER
DIRECTOR, VICE-PRESIDENT
29280 CLASSIC DRIVE
CHESTERFIELD MI 48051-3787

Officer/Director/Trustee Three

RODNEY HARRIS
DIRECTOR - SECRETARY
18826 CAMBRIDGE BLVD
LATHRUP VILLAGE MI 48076-3388

Officer/Director/Trustee Four

LISA MCCAMANT
DIRECTOR - TREASURER
35181 KESLER COURT
CLINTON MI 48035-2368

Officer/Director/Trustee Five

BOB WALMSLEY
DIRECTOR
37945 PINERIDGE
HARRISON MI 48045-3488

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/1/19
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B12 - Fund Raising and/or Fund Distribution
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 GERALD BLAZIUS
Signature Title DIRECTOR, CHAIR, PRESIDENT
Signature Date 6/4/19

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