FORM 1023-EZ for FIRST RESPONDERS RESILIENCY INC

Field Data
EIN 82-4439334
Case Number EO-2018099-000036
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name FIRST RESPONDERS RESILIENCY INC
Organization’s Mailing Address 4717 CARISSA AVE
City SANTA ROSA
State CA
ZIP 95405
Accounting period End 12
Primary contact name DARYL REESE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SUSAN FARREN
DIRECTOR/PRESIDENT
4717 CARISSA AVE
SANTA ROSA CA 95405

Officer/Director/Trustee Two

TOM CHRISTENSEN
DIRECTOR/SECRETARY
4717 CARISSA AVE
SANTA ROSA CA 95405

Officer/Director/Trustee Three

MATTHEW EVERSON
DIRECTOR/TREASURER
4717 CARISSA AVE
SANTA ROSA CA 95405

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/15/18
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F99 - Mental Health, Crisis Intervention N.E.C.
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 SUSAN FARREN
Signature Title DIRECTOR/PRESIDENT
Signature Date 4/7/18

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