| Field | Data |
|---|---|
| EIN | 86-2615600 |
| Case Number | EO-2021097-001288 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | BENTON COUNTY CRITICAL INCIDENT STRESS MANAGEMENT TEAM |
| Organization’s Mailing Address | 98 MAIN STREET |
| City | VAN HORNE |
| State | IA |
| ZIP | 52346-9747 |
| Accounting period End | 12 |
| Primary contact name | BRAXTON MORRISON 319-521-5154 |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
BRAXTON MORRISON
PRESIDENT
906 C AVENUE
VINTON IA 52349-1355
KIMBERLY RAYMAN
VICE PRESIDENT
111 1ST STREET
VAN HORNE IA 52346-9850
JEREMY HLAS
TREASURER
601 2ND AVENUE
VAN HORNE IA 52346-9722
JENNIFER LOSENICKY
SECRETARY
102 SOUTH LINDEN AVENUE PO BOX 141
GARRISON IA 52229-0141
| Organization’s website | |
|---|---|
| Organization’s email | BENTONCOCISM@GMAIL.COM |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 2/3/2021 |
| Organization Incorporation State | IA |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | F99 - Mental Health, Crisis Intervention N.E.C. |
| 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 | Yes |
| 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 | BRAXTON MORRISON |
| Signature Title | PRESIDENT |
| Signature Date | 3/15/2021 |
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