FORM 1023-EZ for FRIENDS OF CROSSROADS CLUBHOUSE-WARREN

Field Data
EIN 86-1804719
Case Number EO-2021089-000499
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name FRIENDS OF CROSSROADS CLUBHOUSE-WARREN
Organization’s Mailing Address 27041 SCHOENHERR RD STE A
City WARREN
State MI
ZIP 48088
Accounting period End 12
Primary contact name RAY JEWHURST
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PATRICIA THAAR-NOVAK
PRESIDENT
2820 W MAPLE RD STE 128
TROY MI 48084

Officer/Director/Trustee Two

BRIANA JACOB
SECRETARY
35031 23 MILE RD
NEW BALTIMORE MI 48047

Officer/Director/Trustee Three

ELIZABETH PYDEN
TREASURER
37504 CAMELLIA LANE
CLINTON TWP MI 48036

Officer/Director/Trustee Four

RAY JEWHURST
MEMBER AT LARGE
15296 FRAZHO
ROSEVILLE MI 48066

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/18/2019
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P01 - Alliance/Advocacy Organizations
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: Yes
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 Yes
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 RAY JEWHURST
Signature Title MEMBER AT LARGE
Signature Date 2/11/2021

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