FORM 1023-EZ for PROFESSIONAL MEDIATION BOARD OF STANDARDS

Field Data
EIN 47-4962758
Case Number EO-2015251-000273
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PROFESSIONAL MEDIATION BOARD OF STANDARDS
Organization’s Mailing Address 3600 AMERICAN BLVD W STE 105
City BLOOMINGTON
State MN
ZIP 55431
Accounting period End 12
Primary contact name JENNIFER URBAN - CAF NO 0308-14263R
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MARILYN MCKNIGHT
PRESIDENT + DIRECTOR
3600 AMERICAN BLVD W STE 105
BLOOMINGTON MN 55431

Officer/Director/Trustee Two

STEVEN BOYD MENACK
VICE PRESIDENT + DIRECTOR
49 BRIARCLIFF RD
MOUNTAIN LAKES NJ 07046-1304

Officer/Director/Trustee Three

VICTORIA COLEMAN
SECRETARY + DIRECTOR
40 E CHICAGO AVE STE 311
CHICAGO IL 60611-2026

Officer/Director/Trustee Four

LAWRENCE GAUGHAN
TREASURER + DIRECTOR
11800 SUNRISE VALLEY DR SE 320
RESTON VA 20191-5302

Officer/Director/Trustee Five

PAULA TROUT
DIRECTOR
1350 E FLAMINGO RD STE 604
LAS VEGAS NV 89119-5263

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/18/2013
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code I51 - Dispute Resolution, Mediation Services
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 Yes
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 Yes
One Third Support Gifts No
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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