FORM 1023-EZ for ALACHUA COUNTY PERINATAL MENTAL HEALTH COALITION INC

Field Data
EIN 81-4547117
Case Number EO-2016342-000155
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ALACHUA COUNTY PERINATAL MENTAL HEALTH COALITION INC
Organization’s Mailing Address 1810 NW 6TH ST STE E
City GAINESVILLE
State FL
ZIP 32609
Accounting period End 12
Primary contact name LAUREN DEPAOLA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LAUREN DEPAOLA
PRESIDENT, DIRECTOR
17698 NW 181ST ST
ALACHUA FL 32615

Officer/Director/Trustee Two

EMORY SPRINGFIELD
SECRETARY, DIRECTOR
1810 NW 6TH ST STE E
GAINESVILLE FL 32609

Officer/Director/Trustee Three

JAMES ANDRISIN
TREASURER, DIRECTOR
1810 NW 6TH ST STE E
GAINESVILLE FL 32609

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/29/2016
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - 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 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 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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