FORM 1023-EZ for BLACK BOTTOM GUN CLUB

Field Data
EIN 85-0722306
Case Number EO-2020196-000471
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BLACK BOTTOM GUN CLUB
Organization’s Mailing Address 18316 HANNA ST
City MELVINDALE
State MI
ZIP 48122
Accounting period End 12
Primary contact name CHAD J KING
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CHAD KING
PRESIDENT AND DIRECTOR
18316 HANNA ST
MELVINDALE MI 48122

Officer/Director/Trustee Two

C KOFI KENYATTA
VICE PRESIDENT AND DIRECTOR
15210 KENWOOD
OAK PARK MI 48237

Officer/Director/Trustee Three

JESSICA KELLEY
MANAGER AND DIRECTOR
10876 PREVOST
DETROIT MI 48235

Officer/Director/Trustee Four

LILLIAN LAVETTE GIST
SECRETARY AND DIRECTOR
3863 NORWICH DR
CANTON MI 48188

Officer/Director/Trustee Five

ROSS PALMER
TRAINER AND DIRECTOR
40436 E MICHIGAN AVE SUITE 305
CANTON MI 48198

Organization’s website BLACKBOTTOMGUNCLUB.COM
Organization’s email BLACKBOTTOMGC@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/9/2020
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code M40 - Safety Education
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 CHAD KING
Signature Title PRESIDENT AND DIRECTOR
Signature Date 6/12/2020

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