FORM 1023-EZ for BLACK MINDS MATTER PSYCHOTHERAPY INC
| Field | Data |
|---|---|
| EIN | 87-0899380 |
| Case Number | EO-2021183-000461 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | BLACK MINDS MATTER PSYCHOTHERAPY INC |
| Organization’s Mailing Address | 888 4TH ST 11 |
| City | SAN RAFAEL |
| State | CA |
| ZIP | 94901 |
| Accounting period End | 4 |
| Primary contact name | REUBEN BURKE |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
REUBEN BURKE
CEO & PRESIDENT&DIRECTOR
205 MARINA LAKES DRIVE
RICHMOND CA 94804
Officer/Director/Trustee Two
WINIFRED CRITTENDEN
TREASURER
888 4TH ST SUITE 11
SAN RAFAEL CA 94901
Officer/Director/Trustee Three
DEBORAH SPAKE
SECRETARY
888 4TH ST SUITE 11
SAN RAFAEL CA 94901
| Organization’s website | |
|---|---|
| Organization’s email | BREUBEN47@GMAIL.COM |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 5/4/2021 |
| Organization Incorporation State | CA |
| 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: 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 | Yes |
| 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 | REUBEN BURKE |
| Signature Title | CEO & PRESIDENT&DIRECTOR |
| Signature Date | 6/30/2021 |
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