FORM 1023-EZ for CHAMPIONS FOR HD

Field Data
EIN 83-0592717
Case Number EO-2018239-000470
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CHAMPIONS FOR HD
Organization’s Mailing Address 3617 DEVONSHIRE AVE
City KALAMAZOO
State MI
ZIP 49006
Accounting period End 12
Primary contact name SHELBY LENTZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHELBY LENTZ
DIRECTOR
3617 DEVONSHIRE AVE
KALAMAZOO MI 49006

Officer/Director/Trustee Two

DANIEL BALLOCK
BOARD MEMBER
523 RIVERVIEW
KALAMAZOO MI 49009

Officer/Director/Trustee Three

TRACY DERHAMMER
BOARD MEMBER
3617 DEVONSHIRE AVE
KALAMAZOO MI 49006

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/3/18
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G12 - Fund Raising and/or Fund Distribution
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 Yes
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 SHELBY LENTZ
Signature Title DIRECTOR
Signature Date 8/23/18

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