FORM 1023-EZ for PINEYS PLACE INC

Field Data
EIN 81-4072511
Case Number EO-2017044-000505
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PINEYS PLACE INC
Organization’s Mailing Address 30550 GRATIOT AVE UNIT 364
City ROSEVILLE
State MI
ZIP 48066
Accounting period End 12
Primary contact name NICOLE RICE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CHANTEL WILLIAMS
OFFICER
27690 PARKVIEW BLVD APT 502
WARREN MI 48092

Officer/Director/Trustee Two

HELENA KELLY
OFFICER
735 HILLCREST CIRCLE
AUBURN HILLS MI 48236

Officer/Director/Trustee Three

NICOLE RICE
DIRECTOR
PO BOX 364
ROSEVILLE MI 48066

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/28/2016
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F33 - Group Home, Residential Treatment Facility - Mental Health Related
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 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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