FORM 1023-EZ for CROSSINGBRIDGES COUNSELING SERVICESINC

Field Data
EIN 82-3848525
Case Number EO-2018102-000197
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CROSSINGBRIDGES COUNSELING SERVICESINC
Organization’s Mailing Address 3739 BRIAR RUN DRIVE
City CLERMONT
State FL
ZIP 34711
Accounting period End 12
Primary contact name DAISY ROMAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DAISY ROMAN
CHIEF EXECUTIVE OFFICER
3739 BRIAR RUN DRIVE
CLERMONT FL 34711

Officer/Director/Trustee Two

TONY SHAW
OFFICER TREASURER
3872 LONG BRANCH LANE
CLERMONT FL 32712

Officer/Director/Trustee Three

DONNA AUSTIN
OFFICER SECRETARY
14832 MASTHEAD LANDING
WINTER GARDEN FL 34787

Officer/Director/Trustee Four

DAVID ALVARADO
MEMBER
157 PROVIDENCE STREET
WORCESTER MA 1604

Officer/Director/Trustee Five

DAISY ROMAN
OFFICER
3739 BRIAR RUN DRIVE
CLERMONT FL 34711

Organization’s website
Organization’s email CROSSING.BRIDGES@OUTLOOK.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/10/18
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F70 - Mental Health Disorders
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 Yes
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name DAISY ROMAN
Signature Title OFFICER
Signature Date 4/8/18

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