FORM 1023-EZ for SUICIDE PREVENTION ALLIANCE
| Field | Data |
|---|---|
| EIN | 85-3004979 |
| Case Number | EO-2020287-000337 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | SUICIDE PREVENTION ALLIANCE |
| Organization’s Mailing Address | 1690 BRITANNIA COURT |
| City | HARRISBURG |
| State | PA |
| ZIP | 17112-8542 |
| Accounting period End | 6 |
| Primary contact name | GOVAN A MARTIN III |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
GOVAN MARTIN
DIRECTOR, CHAIRMAN AND PRESIDENT
1690 BRITANNIA COURT
HARRISBURG PA 17112-8542
Officer/Director/Trustee Two
JACQUELINE BOXTER-BUSH
DIRECTOR AND TREASURER
136 MT EAGLE TRAIL ROAD
TOWER CITY PA 17980-9437
Officer/Director/Trustee Three
MARY BROWN
DIRECTOR, SECTRETARY VICE-CHAIRMAN
1143 TREASURE LAKE
DUBOIS PA 15801-9027
Officer/Director/Trustee Four
AMANDA HAMMOCK
DIRECTOR
36 PROVIDENCE ROAD
MORTON PA 19070-1134
Officer/Director/Trustee Five
SEAMUS KELLEHER
DIRECTOR
26 LENAPE LANE
DOYLESTOWN PA 18901-2936
| Organization’s website | N/A |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 8/28/2020 |
| Organization Incorporation State | PA |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | F11 - Single Organization Support |
| 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 | Yes |
| Donation of funds | Yes |
| Conducting Activities Outside of United States | No |
| Financial transactions with officers | No |
| Unrelated Gross Income $1,000 or More | No |
| Gaming Activity | Yes |
| 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 | GOVAN MARTIN |
| Signature Title | DIRECTOR, CHAIRMAN AND PRESIDENT |
| Signature Date | 10/8/2020 |
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