FORM 1023-EZ for HARBOR COUNTRY MISSION

Field Data
EIN 46-4817933
Case Number EO-2016224-000522
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HARBOR COUNTRY MISSION
Organization’s Mailing Address 13100 RED ARROW HWY
City SAWYER
State MI
ZIP 49125
Accounting period End 12
Primary contact name JASON EHLERT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JASON EHLERT
PRESIDENT, DIRECTOR
6087 MIGIEL LN
SAWYER MI 49125

Officer/Director/Trustee Two

JORDAN KLINT
SECRETARY, DIRECTOR
11246 GAST RD
BRIDGMAN MI 49106

Officer/Director/Trustee Three

DAVE HEYN
TREASURER, DIRECTOR
3735 LAKE ST
BRIDGMAN MI 49106

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/7/2014
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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 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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