FORM 1023-EZ for HURON VALLEY ATHLETIC CLUB INC

Field Data
EIN 30-0329357
Case Number EO-2017006-000171
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HURON VALLEY ATHLETIC CLUB INC
Organization’s Mailing Address 527 UNION ST
City MILFORD
State MI
ZIP 48381-1685
Accounting period End 12
Primary contact name JODI SOLECKI
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DOUGLAS KLINGENSMITH
PRESIDENT
527 UNION ST
MILFORD MI 48381-1685

Officer/Director/Trustee Two

BRIAN LAKKIDES
VICE PRESIDENT
487 RIVER OAKS DR
MILFORD MI 48381-1038

Officer/Director/Trustee Three

TIFFANY KLINGENSMITH
TREASURER
527 UNION ST
MILFORD MI 48381-1685

Officer/Director/Trustee Four

RENEE CHAMPANE
SECRETARY
158 RAVINESIDE DR
MILFORD MI 48381-2831

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/1/2005
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N12 - 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 Yes
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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