FORM 1023-EZ for MENTAL HEALTH AWARENESS OF MICHIANAINC

Field Data
EIN 82-4359500
Case Number EO-2018078-000611
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MENTAL HEALTH AWARENESS OF MICHIANAINC
Organization’s Mailing Address 132 MARQUETTE AVENUE
City SOUTH BEND
State IN
ZIP 46617
Accounting period End 12
Primary contact name JAMES J KELLY JR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LISA KELLY
PRESIDENT
132 MARQUETTE AVENUE
SOUTH BEND IN 46617

Officer/Director/Trustee Two

JAMES KELLY
SECRETARY
132 MARQUETTE AVENUE
SOUTH BEND IN 46617

Officer/Director/Trustee Three

HEATHER HOLLEMAN
TREASURER
18340 ROOSEVELT ROAD
SOUTH BEND IN 46614

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/9/18
Organization Incorporation State IN
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: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence Yes
Compensation of Officer director trustee Yes
Donation of funds Yes
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 LISA KELLY
Signature Title PRESIDENT
Signature Date 3/17/18

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