FORM 1023-EZ for ASSOCIATION FOR COMMUNITY INTEGRATION PROGRAMS INC

Field Data
EIN 47-2254417
Case Number EO-2015222-000352
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ASSOCIATION FOR COMMUNITY INTEGRATION PROGRAMS INC
Organization’s Mailing Address 406 MASSACHUSETTS AVENUE SUITE 3
City ARLINGTON
State MA
ZIP 02474
Accounting period End 12
Primary contact name TIM HALEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ROSS ELLENHORN
PRESIDENT
22 ELMORE STREET
ARLINGTON MA 02476

Officer/Director/Trustee Two

TIMOTHY HALEY
TREASURER
32 PRINCETON ROAD
ARLINGTON MA 02474

Officer/Director/Trustee Three

PETE LINNETT
SECRETARY
11936 W JEFFERSON BLVD
CULVER CITY CA 90230

Officer/Director/Trustee Four

BRAD KENNEDY
DIRECTOR
12301 S MAIN ST
HOUSTON TX 77035

Organization’s website HTTP://A4CIP.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/14/2014
Organization Incorporation State MA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F80 - Mental Health Association, Multipurpose
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 No
One Third Support Gifts Yes
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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