FORM 1023-EZ for PROFESSIONAL COUNSELORS AND MEDIATION SERVICES OF MID MICHIGAN LLC

Field Data
EIN 47-3270778
Case Number EO-2016204-000069
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PROFESSIONAL COUNSELORS AND MEDIATION SERVICES OF MID MICHIGAN LLC
Organization’s Mailing Address 3938 TRUXTON LN
City LANSING
State MI
ZIP 48911
Accounting period End 12
Primary contact name BEVERLY RAINEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DR TIMUR BARUTI
PRESIDENT
207 E BELLEVUE ST
LESLIE MI 49251

Officer/Director/Trustee Two

LATOSHIA BARUTI
VICE PRESIDENT
207 E BELLEVUE ST
LESLIE MI 49251

Officer/Director/Trustee Three

BEVERLY RAINEY
CEO/EXEC DIRECTOR
3938 TRUXTON LN
LANSING MI 48911

Officer/Director/Trustee Four

NICOLETTA GRACE
TREASURER
913 W HOLMES RD STE B146
LANSING MI 48910

Officer/Director/Trustee Five

PATRICA HOSKINS
SECRETARY
3333 MOORES RIVER DR 202
LANSING MI 48911

Organization’s website HTTP://WWW.PROCOUNSELING.ORG
Organization’s email BEVERLY.RAINEY@PROCOUNSELING.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/13/2015
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F30 - Mental Health Treatment - Multipurpose and N.E.C.
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
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 No
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More Yes
Gaming Activity No
Disaster relief assistance No
One Third Support Public No
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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