FORM 1023-EZ for VALARIE L MITCHELL

Field Data
EIN 47-4727039
Case Number EO-2015230-000145
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name VALARIE L MITCHELL
Organization’s Mailing Address 28963 GLENCASTLE DRIVE
City FARMINGTON HILLS
State MI
ZIP 48336
Accounting period End 12
Primary contact name VALARIE MITCHELL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

VALARIE MITCHELL
EXECUTIVE DIRECTOR
28963 GLENCASTLE DR
FARMINGTON HILLS MI 48336

Officer/Director/Trustee Two

BASSAM SENAWI
BOARD CHAIRPERSON
1300 W 8 MILE
OAK PARK MI 48237

Officer/Director/Trustee Three

MOTIA THABET
BOARD TREASURER
4252 CALHOUN ST
DEARBORN MI 48126

Officer/Director/Trustee Four

CLARENCE JONES
BOARD SECRETARY
1719 E GRAND BLVD
DETROIT MI 48211

Officer/Director/Trustee Five

DANIEL OSOWSKI
BOARD MEMBER
28115 GREENMEADOW CIRCLE WEST
FARMINGTON HILLS MI 48334

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/7/2015
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O01 - Alliance/Advocacy Organizations
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 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
Signature Title
Signature Date

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