FORM 1023-EZ for MICHIGAN PHYSIOLOGICAL SOCIETY

Field Data
EIN 46-3041520
Case Number EO-2015133-000109
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MICHIGAN PHYSIOLOGICAL SOCIETY
Organization’s Mailing Address 567 WILSON RD RM 2195
City EAST LANSING
State MI
ZIP 48824
Accounting period End 5
Primary contact name JAMES MICHAEL POTERACKI
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ERICA WEHRWEIN
PRESIDENT
567 WILSON RD RM 2195
EAST LANSING MI 48824

Officer/Director/Trustee Two

JASON CARTER
PAST PRESIDENT
1400 TOWNSEND DRIVE
HOUGHTON MI 49931

Officer/Director/Trustee Three

JAMES POTERACKI
SECRETARY TREASURER
567 WILSON RD RM 2201
EAST LANSING MI 48824

Officer/Director/Trustee Four

PATRICK MUELLER
PRESIDENT ELECT
540 E CANFIELD
DETROIT MI 48201

Organization’s website APSMICHIGAN.ORG
Organization’s email PHYSIOLOGY@APSMICHIGAN.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/28/2013
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code U03 - Professional Societies, Associations
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
Scientific: Yes
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 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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