FORM 1023-EZ for MIND HEALTH CONNECTION A NJ NONPROFIT CORPORATION

Field Data
EIN 37-1852324
Case Number EO-2020139-000390
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MIND HEALTH CONNECTION A NJ NONPROFIT CORPORATION
Organization’s Mailing Address 525 ROUTE 73 NORTH SUITE 104
City MARLTON
State NJ
ZIP 08053
Accounting period End 6
Primary contact name CHERYL THOMAS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CHERYL THOMAS
CEO
35 ELSWORTH DRIVE
SICKLERVILLE NJ 08081

Officer/Director/Trustee Two

ANN NDUATI
TRUSTEE
35 ELSWORTH DRIVE
SICKLERVILLE NJ 08081

Officer/Director/Trustee Three

ANDREW NDUATI
TRUSTEE
35 ELSWORTH DRIVE
SICKLERVILLE NJ 08081

Organization’s website HTTP://WWW.MINDHEALTHCONNECTION.ORG
Organization’s email INFO@MINDHEALTHCONNECTION.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/15/2015
Organization Incorporation State NJ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E70 - Public Health Program (Includes General Health and Wellness Promotion Services)
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
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 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 CHERYL THOMAS
Signature Title CEO
Signature Date 5/15/2020

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