FORM 1023-EZ for ATASCOSA COUNTY MENTAL HEALTH ADVISORY BOARD

Field Data
EIN 84-3954278
Case Number EO-2020073-000271
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ATASCOSA COUNTY MENTAL HEALTH ADVISORY BOARD
Organization’s Mailing Address 1279 WEST HWY 97
City JOURDANTON
State TX
ZIP 78026
Accounting period End 12
Primary contact name RUSSELL PRASIFKA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RUSSELL PRASIFKA
PRESIDENT
134 MASSAD
PLEASANTON TX 78064

Officer/Director/Trustee Two

CYNTHIA GUTIERREZ
TREASURER
45 PULLIAM
PLEASANTON TX 78064

Officer/Director/Trustee Three

LORI KESSLER
MEMBER
1275 CR 328
JOURDANTON TX 78026

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/17/1983
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F12 - Fund Raising and/or Fund Distribution
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 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 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 RUSSELL PRASIFKA
Signature Title PRESIDENT
Signature Date 3/11/2020

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