FORM 1023-EZ for BLOOMFIELD HILLS LACROSSE CLUB INC

Field Data
EIN 82-1389011
Case Number EO-2017165-000155
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BLOOMFIELD HILLS LACROSSE CLUB INC
Organization’s Mailing Address 6743 WHITE PINE CT
City BLOOMFIELD HILLS
State MI
ZIP 48302
Accounting period End 12
Primary contact name AVIS NAJOR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LARRY GUTOWSKY
DIRECTOR OF OPERATIONS
3925 OAKLAND DRIVE
BLOOMFIELD HILLS MI 48301

Officer/Director/Trustee Two

AVIS NAJOR
MANAGING DIRECTOR
6743 WHITE PINE CT
BLOOMFIELD HILLS MI 48301

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/20/2017
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N60 - Amateur Sports Clubs, Leagues, N.E.C.
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 Yes
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
Signature Title
Signature Date

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