FORM 1023-EZ for PSYCHOSOCIAL SERVICES CENTER INC

Field Data
EIN 84-1838305
Case Number EO-2020122-000230
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PSYCHOSOCIAL SERVICES CENTER INC
Organization’s Mailing Address 3 NE 12TH AVE
City CHIEFLAND
State FL
ZIP 32626
Accounting period End 12
Primary contact name LEYDA SANTIAGO
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LEYDA SANTIAGO
PRESIDENT
3 NE 12TH AVE
CHIEFLAND FL 32626

Officer/Director/Trustee Two

ROBERTO ACEVEDO MARTELL
VICE PRESIDENT
3 NE 12TH AVE
CHIEFLAND FL 32626

Officer/Director/Trustee Three

ROBERTO ACEVEDO SANTIAGO
TREASURER
3 NE 12TH AVE
CHIEFLAND FL 32626

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/23/2019
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B11 - Single Organization Support
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: Yes
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name ROBERTO ACEVEDO MARTELL
Signature Title VICE PRESIDENT
Signature Date 4/29/2020

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