FORM 1023-EZ for REVIVE MENTAL HEALTH

Field Data
EIN 87-1542300
Case Number EO-2021189-000220
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name REVIVE MENTAL HEALTH
Organization’s Mailing Address 2521 CIMA HILL DRIVE
City PLANO
State TX
ZIP 75025
Accounting period End 8
Primary contact name JADA ATCHU-YUDOM
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JADA ATCHU-YUDOM
EXECUTIVE DIRECTOR
2521 CIMA HILL DRIVE
PLANO TX 75025

Officer/Director/Trustee Two

SANIA AHMAD
EXECUTIVE DIRECTOR
3624 BANKS CIRCLE
PLANO TX 75025

Organization’s website REVIVEMENTALHEALTH.ORG
Organization’s email CONTACT@REVIVEMENTALHEALTH.ORG
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/5/2020
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F01 - Alliance/Advocacy Organizations
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 Yes
Conducting Activities Outside of United States Yes
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name JADA ATCHU-YUDOM
Signature Title EXECUTIVE DIRECTOR
Signature Date 7/6/2021

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