FORM 1023-EZ for SOUTHWESTERN INDIANA SUICIDE PREVENTION COALITION

Field Data
EIN 84-1843712
Case Number EO-2019158-000270
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SOUTHWESTERN INDIANA SUICIDE PREVENTION COALITION
Organization’s Mailing Address 7200 E INDIANA STREET
City EVANSVILLE
State IN
ZIP 47715-2753
Accounting period End 12
Primary contact name JANIE CHAPPELL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JANIE CHAPPELL
PRESIDENT
7200 E INDIANA STREET
EVANSVILLE IN 47715-2753

Officer/Director/Trustee Two

EMILY REIDFORD
VICE-PRESIDENT
PO BOX 3207
EVANSVILLE IN 47731

Officer/Director/Trustee Three

LAURA KEYS
SECRETARY
PO BOX 3897
EVANSVILLE IN 47737

Officer/Director/Trustee Four

MICHELLE YOUNG
TREASURER
4488 ROSLIN ROAD
NEWBURGH IN 47630

Organization’s website
Organization’s email JANIE.CHAPPELL@DEACONESS.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/22/19
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F01 - Alliance/Advocacy Organizations
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 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 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 JANIE CHAPPELL
Signature Title PRESIDENT
Signature Date 6/5/19

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