FORM 1023-EZ for CHILDRENS TRAUMA ASSESSMENT GROUP OF ST JOSEPH COUNTY INC

Field Data
EIN 47-1197869
Case Number EO-2014224-000195
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CHILDRENS TRAUMA ASSESSMENT GROUP OF ST JOSEPH COUNTY INC
Organization’s Mailing Address 664 EAST MAIN STREET
City CENTREVILLE
State MI
ZIP 49032
Accounting period End 12
Primary contact name LAURIE ANN HINES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DEANA STRUDWICK
PRESIDENT
19900 GRASS LAKE LANE
WHITE PIGEON MI 49099

Officer/Director/Trustee Two

CHRISTIE BALLARD
SECRETARY
65824 SCENIC VIEW DRIVE
STRUGIS MI 49091

Officer/Director/Trustee Three

NATALIE BOLAND
TREASURER
915 GRAND AVENUE
STURGIS MI 49091

Officer/Director/Trustee Four

LYNELLE THRASHER
DIRECTOR
677 EAST MAIN STREET
CENTREVILLE MI 49032

Officer/Director/Trustee Five

CHRISTINE YANCEY
DIRECTOR
129 WEST MAIN STREET
MENDON MI 49072

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/18/2014
Organization Incorporation State MI
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: 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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