FORM 1023-EZ for 6TH ALARM PEER SUPPORT INC

Field Data
EIN 82-1876456
Case Number EO-2017172-000191
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name 6TH ALARM PEER SUPPORT INC
Organization’s Mailing Address PO BOX 2001
City WEST LAFAYETTE
State IN
ZIP 47996-2001
Accounting period End 12
Primary contact name MICHAEL HIEATT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MICHAEL HIEATT
PRESIDENT
2212 KINGSBURY DRIVE
LAFAYETTE IN 47909-8440

Officer/Director/Trustee Two

TODD TRENT
VICE PRESIDENT
816 NORTH 600 EAST
FLORA IN 46929-9343

Officer/Director/Trustee Three

GEOFF CARLSON
SECRETARY-TREASURER
11473 EAST 1100 NORTH
OTTERBEIN IN 47970-8004

Officer/Director/Trustee Four

DAVID KARLSTRAND
TRUSTEE
3110 B CHARDONNAY CT
LAFAYETTE IN 47909-6932

Officer/Director/Trustee Five

MATT KUBAT
TRUSTEE
1102 NORTH 1200 WEST
BATTLEGROUND IN 47920-8025

Organization’s website WWW.6THALARM.COM
Organization’s email BOARD_OF_DIRECTORS@6THALARM.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/15/2017
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F60 - Counseling, Support Groups
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 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
Signature Title
Signature Date

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