FORM 1023-EZ for SOUND MIND

Field Data
EIN 47-4163577
Case Number EO-2015306-000465
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SOUND MIND
Organization’s Mailing Address 300 FRONT ST
City MULLENS
State WV
ZIP 25882
Accounting period End 12
Primary contact name ANTHONY BAILEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ANTHONY BAILEY
PRESIDENT
126 PEBBLESTONE DR
BECKLEY WV 25801

Officer/Director/Trustee Two

PHILLIP HALSEY
VICE PRESIDENT
800 FRANTZ
MULLENS WV 25882

Officer/Director/Trustee Three

KRISTI HALSEY
SECRETARY
870 GLENVIEW RD
CRAB ORCHARD WV 25827

Officer/Director/Trustee Four

TOMMIE LOU MONGENI
TREASURER
922 CENTER ST
MULLENS WV 25882

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/11/2015
Organization Incorporation State WV
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X20 - Christian
Organization’s purpose Charitable: No
Religious: Yes
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 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 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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