FORM 1023-EZ for VOLTA BEHAVIORAL HEALTH INC

Field Data
EIN 85-0511658
Case Number EO-2020087-000099
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name VOLTA BEHAVIORAL HEALTH INC
Organization’s Mailing Address 9 BARTLET ST SUITE 260
City ANDOVER
State MA
ZIP 01810
Accounting period End 12
Primary contact name DARRELL ST CLEMMONS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DARRELL ST CLEMMONS
PRESIDENT
9 BARTLET ST SUITE 260
ANDOVER MA 01810

Officer/Director/Trustee Two

ANDRIA TUNSTALL
VICE PRESIDENT
9 BARTLET ST SUITE 260
ANDOVER MA 01810

Officer/Director/Trustee Three

ALISA DRIVER
SECRETARY
9 BARTLET ST SUITE 260
ANDOVER MA 01810

Officer/Director/Trustee Four

MICHAEL TUNSTALL
TREASURER
9 BARTLET ST SUITE 260
ANDOVER MA 01810

Organization’s website
Organization’s email VOLTABEHAVIORALHEALTH@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/19/2020
Organization Incorporation State MA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
Organization’s purpose Charitable: Yes
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 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 DARRELL ST CLEMMONS
Signature Title PRESIDENT
Signature Date 3/25/2020

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