FORM 1023-EZ for AKATHISIA ALLIANCE FOR SUICIDE PREVENTION
| Field | Data |
|---|---|
| EIN | 82-4083757 |
| Case Number | EO-2019095-000147 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | AKATHISIA ALLIANCE FOR SUICIDE PREVENTION |
| Organization’s Mailing Address | 45860 CASS AVE 13 |
| City | UTICA |
| State | MI |
| ZIP | 48317-5264 |
| Accounting period End | 3 |
| Primary contact name | JILL NICKENS |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
JILL NICKENS
FOUNDER
45860 CASS AVE 13
UTICA MI 48317-5264
Officer/Director/Trustee Two
TODD NICKENS
CO-FOUNDER
15430 IMLAY CITY RD
MUSSEY TWP MI 48014-2408
Officer/Director/Trustee Three
RUSSELL BAKER
CO-FOUNDER
402 RUM RUN BAHAMA BAY RESORT
DAVENPORT FL 33897
| Organization’s website | AKATHISIAALLIANCE.ORG |
|---|---|
| Organization’s email | WECARE@AKATHISIAALLIANCE.ORG |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 1/25/18 |
| Organization Incorporation State | MI |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | G01 - Alliance/Advocacy Organizations |
| Organization’s purpose | Charitable: Yes Religious: No Educational: No Scientific: Yes 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 | 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 | JILL NICKENS |
| Signature Title | FOUNDER |
| Signature Date | 4/3/19 |
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