FORM 1023-EZ for CALIFORNIA BEHAVIORAL HEALTH ADMINISTRATORS ASSOCIATION

Field Data
EIN 47-1673629
Case Number EO-2014241-000062
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CALIFORNIA BEHAVIORAL HEALTH ADMINISTRATORS ASSOCIATION
Organization’s Mailing Address 1965 LIVE OAK BOULEVARD SUITE A
City YUBA CITY
State CA
ZIP 95991
Accounting period End 6
Primary contact name DONNA THOMPSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DONNA THOMPSON
PRESIDENT
1965 LIVE OAK BOULEVARD SUITE A
YUBA CITY CA 95991

Officer/Director/Trustee Two

ERIN VALDEZ
VICE PRESIDENT
242 NORTH VILLA STREET
WILLOWS CA 95988

Officer/Director/Trustee Three

STEPHANIE HESS
SECRETARY / TREASURER
10877 CONDUCTOR BLVD SUITE 300
SUTTER CREEK CA 95685

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/1/2014
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F03 - Professional Societies, Associations
Organization’s purpose Charitable: No
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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