FORM 1023-EZ for MID-ATLANTIC CHAPTER OF ACBS

Field Data
EIN 45-5187066
Case Number EO-2015306-000499
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MID-ATLANTIC CHAPTER OF ACBS
Organization’s Mailing Address 801 COLBY AVE
City TAKOMA PARK
State MD
ZIP 20912
Accounting period End 12
Primary contact name MIRANDA MORRIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MIRANDA MORRIS
PRESIDENT
801 COLBY AVE
TAKOMA PARK MD 20912

Officer/Director/Trustee Two

STACI MARTIN
PRESIDENT ELECT
5011 CLOISTER DR
ROCKVILLE MD 20853

Officer/Director/Trustee Three

AMELIA GOODYEAR
TREASURER
11119 NEWPORT MILL RD
KENSINGTON MD 20895

Officer/Director/Trustee Four

CHRIS WEMPLE
SECRETARY
4618 RENO ROAD NW
WASHINGTON DC 20008

Officer/Director/Trustee Five

EVAN MARKS
DIRECTOR
4405 EAST WEST HWY
BETHESDA MD 20814

Organization’s website
Organization’s email DRMIRANDAMORRIS@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/13/2015
Organization Incorporation State MD
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 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 Yes
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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