FORM 1023-EZ for UTAH ASSOCIATION FOR INFANT MENTAL HEALTH

Field Data
EIN 30-0162078
Case Number EO-2018094-000024
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name UTAH ASSOCIATION FOR INFANT MENTAL HEALTH
Organization’s Mailing Address 123 SECOND AVENUE UNIT 604
City SALT LAKE CITY
State UT
ZIP 84103-4716
Accounting period End 5
Primary contact name SUSAN ORD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JENNIFER MITCHELL
PRESIDENT-OFFICER
5242 SOUTH 4820 WEST
KEARNS UT 84118-6422

Officer/Director/Trustee Two

SUSAN ORD
TREASURER-OFFICER
123 SECOND AVENUE UNIT 604
SALT LAKE CITY UT 84103-4716

Officer/Director/Trustee Three

CODIE THURGOOD
SECRETARY-OFFICER
195 NORTH 1950 WEST
SALT LAKE CITY UT 84116-3100

Officer/Director/Trustee Four

ILSE DEKOEYER-LAROS
PAST PRESIDENT - OFFICER
217 EAST HUBBARD AVENUE
SALT LAKE CITY UT 84111-4615

Officer/Director/Trustee Five

BACALL HINCKS
PRESIDENT ELECT-OFFICER
655 EAST 4500 SOUTH SUITE 200
SALT LAKE CITY UT 84107-2969

Organization’s website UAIMH.ORG
Organization’s email SUZIMORD@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/31/03
Organization Incorporation State UT
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: 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 JENNIFER MITCHELL
Signature Title PRESIDENT-OFFICER
Signature Date 3/30/18

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