FORM 1023-EZ for DOWNRIVER HOCKEY CLUB

Field Data
EIN 38-4006205
Case Number EO-2018284-000106
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name DOWNRIVER HOCKEY CLUB
Organization’s Mailing Address PO BOX 1400
City SOUTHGATE
State MI
ZIP 48195
Accounting period End 5
Primary contact name MARCEL DUPUIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CHRISTIAN BOLLER
PRESIDENT
17636 AZALEA CT
BROWNSTOWN MI 48173

Officer/Director/Trustee Two

MARCEL DUPUIS
TREASURER
15655 WARWICK AVE
ALLEN PARK MI 48101

Officer/Director/Trustee Three

FARO GAGILIO
SECRETARY
20499 LAW AVE
BROWNSTOWN MI 48183

Officer/Director/Trustee Four

PAT JESUE
DIRECTOR
8006 ROSEDALE BLVD
ALLEN PARK MI 48101

Officer/Director/Trustee Five

KREG KELLY
DIRECTOR
2515 EDGEMONT ST
TRENTON MI 48183

Organization’s website WWW.DOWNRIVEROTTERS.COM
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/27/16
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N68 - Winter Sports (Snow and Ice)
Organization’s purpose Charitable: No
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 MARCEL DUPUIS
Signature Title TREASURER
Signature Date 10/9/18

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