FORM 1023-EZ for MARTIAL ARTS MENTAL HEALTH

Field Data
EIN 82-1719410
Case Number EO-2017156-000177
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MARTIAL ARTS MENTAL HEALTH
Organization’s Mailing Address 3100 N ACADEMY SUITE 109
City COLORADO SPRINGS
State CO
ZIP 80917
Accounting period End 7
Primary contact name THERESA VERA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

THERESA VERA
SECRETARY/TREASURER
3370 BRIDGEWATER DR
COLORADO SPRINGS CO 80916

Officer/Director/Trustee Two

STEPHEN CHRISTOPHER
PRESIDENT
3401 PARKMOOR VILLAGE DR APT A
COLORADO SPRINGS CO 80917

Officer/Director/Trustee Three

CONSUELO MARROQUIN
VICE PRESIDENT
2534 HATCH CIR
COLORADO SPRINGS CO 80918

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/23/2017
Organization Incorporation State CO
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: No
Religious: No
Educational: Yes
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 Yes
Donation of funds Yes
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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