FORM 1023-EZ for THE SOCIETY OF BLACK MENTAL HEALTHPROFESSIONALS INC

Field Data
EIN 85-2660842
Case Number EO-2020239-000137
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name THE SOCIETY OF BLACK MENTAL HEALTHPROFESSIONALS INC
Organization’s Mailing Address 3032 SMITH STREET
City FORT WAYNE
State IN
ZIP 46806
Accounting period End 12
Primary contact name CRYSTAL KELLY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CRYSTAL KELLY
PRESIDENT
408 GREENPOINTE PKWAY
FORT WAYNE IN 46814

Officer/Director/Trustee Two

JOYCE STRONG
VICE PRESIDENT
3032 SMITH STREET
FORT WAYNE IN 46806

Officer/Director/Trustee Three

PAULA MARTIN
SECRETARY
3032 SMITH STREET
FORT WAYNE IN 46806

Officer/Director/Trustee Four

MARY PERRY
TREASURER
3032 SMITH STREET
FORT WAYNE IN 46806

Organization’s website HTTPS://WWW.THESOCIETYOFBLACKMENTALHEALTHPROFESSIONALS.COM/
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/29/2019
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 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 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 CRYSTAL KELLY
Signature Title PRESIDENT
Signature Date 8/24/2020

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