FORM 1023-EZ for CRUSTY INC

Field Data
EIN 82-3384380
Case Number EO-2017320-000334
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CRUSTY INC
Organization’s Mailing Address 113 LONGWOOD DR SUITE C
City HUNTSVILLE
State AL
ZIP 35801
Accounting period End 12
Primary contact name GINA PORTER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LISA MATHIS
DIRECTOR
2122 RAINCREEK TRAIL
HUNTSVILLE AL 35811

Officer/Director/Trustee Two

SHARON GAD
DIRECTOR
303 GREENSTONE DR
MADISON AL 35758

Officer/Director/Trustee Three

MEGAN CRUTTENDEN
DIRECTOR
7825 HORSESHOE TRAIL
HUNTSVILLE AL 35802

Officer/Director/Trustee Four

GINA PORTER
DIRECTOR
2701 WOODVIEW DR
HUNTSVILLE AL 35801

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/23/2017
Organization Incorporation State AL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F30 - Mental Health Treatment - Multipurpose and 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 No
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
Signature Title
Signature Date

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