FORM 1023-EZ for URBAN MENTAL HEALTH

Field Data
EIN 83-3625844
Case Number EO-2019070-000272
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name URBAN MENTAL HEALTH
Organization’s Mailing Address 2875 LANGDON FARM RD APT 3
City CINCINNATI
State OH
ZIP 45212
Accounting period End 12
Primary contact name ERIN BROWN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ERIN BROWN
CEO
2875 LANGDON FARD RD APT 3
CINCINNATI OH 45212

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/20/19
Organization Incorporation State OH
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: 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 ERIN BROWN
Signature Title CEO
Signature Date 3/8/19

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