FORM 1023-EZ for GRAND BLANC YOUTH LACROSSE

Field Data
EIN 84-3203446
Case Number EO-2021092-000267
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name GRAND BLANC YOUTH LACROSSE
Organization’s Mailing Address 5041 SPRING WELL LN
City GRAND BLANC
State MI
ZIP 48439
Accounting period End 12
Primary contact name SCOTT ROSENBURG
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CHRIS LAROBARDIERE
PRESIDENT
12071 TOWNLINE RD
GRAND BLANC MI 48439

Officer/Director/Trustee Two

SCOTT ROSENBURG
VP & TREASURER
5041 SPRING WELL LN
GRAND BLANC MI 48439

Officer/Director/Trustee Three

DAN DOWLING
SECRETARY
1205 BUSH CREEK DR
GRAND BLANC MI 48439

Organization’s website WWW.GRANDBLANCYOUTHLACROSSE.COM
Organization’s email GRANDBLANCYOUTHLACROSSE@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/30/2019
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N40 - Sports Training Facilities, Agencies
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 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 SCOTT ROSENBURG
Signature Title VP & TREASURER
Signature Date 2/24/2021

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