FORM 1023-EZ for STUDENT MENTAL HEALTH FOUNDATION INC

Field Data
EIN 86-1323441
Case Number EO-2021056-000530
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name STUDENT MENTAL HEALTH FOUNDATION INC
Organization’s Mailing Address 17576 BRYAN ST
City SOUTH BEND
State IN
ZIP 46635
Accounting period End 12
Primary contact name CULLEN PATRICK HARDY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CULLEN HARDY
FOUNDER
17576 BRYAN ST
SOUTH BEND IN 46635

Officer/Director/Trustee Two

BROOKE DAVIS
BOARD MEMBER
17070 BARRYKNOLL WAY
GRANGER IN 46530

Officer/Director/Trustee Three

RYAN COVEY
BOARD MEMBER
20 N 2ND ST SUITE 103
NILES MI 49120

Officer/Director/Trustee Four

KEVIN HARDY
BOARD MEMBER
66 LEAMINGTON LN
HILTON HEAD SC 29928

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/7/2020
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 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 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 CULLEN HARDY
Signature Title FOUNDER
Signature Date 1/9/2021

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