FORM 1023-EZ for NAMI GREATER BERGEN

Field Data
EIN 84-1889353
Case Number EO-2019186-000251
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name NAMI GREATER BERGEN
Organization’s Mailing Address 304 VALLEY BLVD
City WOOD RIDGE
State NJ
ZIP 7075-1243
Accounting period End 12
Primary contact name LARA ZUCKER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LARA ZUCKER
PRESIDENT
245 RIVERDALE ROAD
POMPTON LAKES NJ 7442

Officer/Director/Trustee Two

ERNEST CHENG
TREASURER
401 PARK PLACE APT 3B
FORT LEE NJ 7024

Officer/Director/Trustee Three

JACY MURPHY-PARK
VICE PRESIDENT
176 FORT LEE ROAD APT 2C
LEONIA NJ 7605

Officer/Director/Trustee Four

CRISTINA BLASONI-TOPSIDIS
SECRETARY
982 BOULEVARD
NEW MILFORD NJ 7646

Officer/Director/Trustee Five

MARIE FUCHIDA
TRUSTEE
52 ROOSEVELT STREET
CRESSKILL NJ 7626

Organization’s website HTTPS://NAMIGREATERBERGEN.ORG/
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/20/19
Organization Incorporation State NJ
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 Yes
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 JACY MURPHY-PARK
Signature Title VICE PRESIDENT
Signature Date 7/2/19

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