FORM 1023-EZ for MENTAL HEALTH OF ASSOCIATES A NJ NON PROFIT COPORATION

Field Data
EIN 84-2055598
Case Number EO-2021028-000259
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MENTAL HEALTH OF ASSOCIATES A NJ NON PROFIT COPORATION
Organization’s Mailing Address 110 WASHINGTON ST APT 3F
City EAST ORANGE
State NJ
ZIP 07017
Accounting period End 12
Primary contact name SHANAKAY DEAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHANAKAY DEAN
OFFICER
110 WASHINGTON ST APT 3F
EAST ORANGE NJ 07017

Officer/Director/Trustee Two

LACYANN MOMANYI
DIRECTOR
704 WHARFSIDE COURT
PERTH AMBOY NJ 08861

Officer/Director/Trustee Three

JIMMY MOMANYI
TRUSTEES
704 WHARFSIDE COURT
PERTH AMBOY NJ 08861

Officer/Director/Trustee Four

JAMILIA GOLDEN
TRUSTEES
103 DODD ST
EAST ORANGE NJ 07017

Officer/Director/Trustee Five

VANESSA WEBSTER
TRUSTEES
96 DODD ST
EAST ORANGE NJ 07017

Organization’s website
Organization’s email mhoa@mail.com
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/11/2019
Organization Incorporation State NJ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G02 - Management & Technical Assistance
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 No
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 SHANAKAY DEAN
Signature Title OFFICER
Signature Date 12/8/2020

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