FORM 1023-EZ for SAMUEL R MYERS FOUNDATION FOR SUICIDE AND MENTAL HEALTH AWARENES
| Field | Data |
|---|---|
| EIN | 81-5004778 |
| Case Number | EO-2021260-000302 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | SAMUEL R MYERS FOUNDATION FOR SUICIDE AND MENTAL HEALTH AWARENES |
| Organization’s Mailing Address | 523 BARRY TURN |
| City | MANTENO |
| State | IL |
| ZIP | 60950 |
| Accounting period End | 12 |
| Primary contact name | BRANDON MYERS |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
BRANDON MYERS
PRESIDENT
523 BARRY TURN
MANTENO IL 60950
Officer/Director/Trustee Two
DEBBIE BRUMITT
VICE PRESIDENT
523 BARRY TURN
MANTENO IL 60950
Officer/Director/Trustee Three
KATHLEEN MYERS
TREASURER
523 BARRY TURN
MANTENO IL 60950
Officer/Director/Trustee Four
DAMON MYERS
SECTETARY
523 BARRY TURN
MANTENO IL 60950
Officer/Director/Trustee Five
RICK SELK
DIRECTOR
523 BARRY TURN
MANTENO IL 60950
| Organization’s website | WWW.SAMMYERSFOUNDATION.COM |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 1/18/2017 |
| Organization Incorporation State | IL |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | F70 - Mental Health Disorders |
| 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 | No |
| One Third Support Gifts | Yes |
| Benefit of College | No |
| Private Foundation 508(e) | No |
| Seeking Retroactive Reinstatement | Yes |
| Seeking Section 7 Reinstatement | No |
| Correctness Declaration | Yes |
| Signature Name | BRANDON MYERS |
| Signature Title | PRESIDENT |
| Signature Date | 9/15/2021 |
| EIN | 81-5004778 |
| Case Number | EO-2017044-000480 |
| Form 1023-EZ version | 62014 |
| Eligibility Worksheet | 1 |
| Organization Name | THE SAMUEL R MYERS FOUNDATION FOR SUICIDE AND MENTAL HEALTH AWARENESS |
| Organization’s Mailing Address | 523 BARRY TURN |
| City | MANTENO |
| State | IL |
| ZIP | 60950 |
| Accounting period End | 12 |
| Primary contact name | BRANDON MYERS |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
BRANDON MYERS
PRESIDENT
523 BARRY TURN
MANTENO IL 60950
Officer/Director/Trustee Two
KATHLEEN MYERS
TREASURER
523 BARRY TURN
MANTENO IL 60950
Officer/Director/Trustee Three
DAMON MYERS
SECRETARY
523 BARRY TURN
MANTENO IL 60950
Officer/Director/Trustee Four
DEBBIE BRUMITT
DIRECTOR
549 HARVARD AVENUE
BOURBONNAIS IL 60914
Officer/Director/Trustee Five
JULIETTE CREWS
DIRECTOR
5302 E 9000N RD
MANTENO IL 60950
| Organization’s website | WWW.SAMMYERSFOUNDATION.COM |
|---|---|
| Organization’s email | BMYERS@SAMMYERSFOUNDATION.COM |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 1/6/2017 |
| Organization Incorporation State | IL |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | F70 - Mental Health Disorders |
| 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 | 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 | |
| Signature Title | |
| Signature Date |
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