FORM 1023-EZ for MENTAL HEALTH ASSOCIATION IN INDIANA INC

Field Data
EIN 35-6071355
Case Number EO-2020265-000217
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MENTAL HEALTH ASSOCIATION IN INDIANA INC
Organization’s Mailing Address 10 1/2 NORTH JACKSON STREET
City GREENCASTLE
State IN
ZIP 46135-1512
Accounting period End 12
Primary contact name KAREN MARTOGLIO
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CHRISTINA WAGNER
PRESIDENT
136 HILLTOP LANE
GREENCASTLE IN 46135-9217

Officer/Director/Trustee Two

CHRISTOPHER WEEKS
VICE PRESIDENT
527 ANDERSON ST
GREENCASTLE IN 46135-1728

Officer/Director/Trustee Three

CIERRA FRAZIER
TREASURER
2403 W COUNTY ROAD 1000 N
ROACHDALE IN 46172-9325

Officer/Director/Trustee Four

ERIN FLICK
SECRETARY
4807 E COUNTY ROAD 900 N
BRAZIL IN 47834-7645

Organization’s website WWW.MHAOPC.ORG
Organization’s email KAREN.MARTOGLIO@MHAOPC.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/31/2019
Organization Incorporation State IN
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: 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 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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name CIERRA FRAZIER
Signature Title TREASURER
Signature Date 9/17/2020

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