FORM 1023-EZ for MENTAL JOE INC

Field Data
EIN 83-2728733
Case Number EO-2019038-000099
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MENTAL JOE INC
Organization’s Mailing Address 13814 W BRILES RD
City PEORIA
State AZ
ZIP 85383
Accounting period End 12
Primary contact name JEFF GAMBLE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CHAD MCLEAN
PRESIDENT
13814 W BRILES RD
PEORIA AZ 85383

Officer/Director/Trustee Two

CARI MCLEAN
CHAIRMAN OF THE BOARD
13814 W BRILES RD
PEORIA AZ 85383

Officer/Director/Trustee Three

ROBERT ELDER
VICE CHAIRMAN OF THE BOARD
513 S HUMPHREY AVE
OAK PARK IL 60304

Officer/Director/Trustee Four

TIM RANDAK
TREASURER
2927 ANNIE ST
BOZEMAN MT 59718

Officer/Director/Trustee Five

PATER KAI KNIGHT
SECTRETARY
1234 OATES ST NE
WASHINGTON DC 20002

Organization’s website MENTAL-JOE.COM
Organization’s email CHAD@MENTAL-JOE.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/5/18
Organization Incorporation State AZ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E50 - Rehabilitative Medical Services
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 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 CHAD MCLEAN
Signature Title PRESIDENT
Signature Date 1/29/19

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