| Field | Data |
|---|---|
| EIN | 61-1770777 |
| Case Number | EO-2016285-000249 |
| Form 1023-EZ version | 62014 |
| Eligibility Worksheet | 1 |
| Organization Name | POLK COUNTY CRITICAL INCIDENT STRESS MANAGEMENT TEAM INC |
| Organization’s Mailing Address | 2470 CLOWER LANE |
| City | BARTOW |
| State | FL |
| ZIP | 33830 |
| Accounting period End | 12 |
| Primary contact name | ROSA LALONDE |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
ROSA LALONDE
PRESIDENT
1465 MAPLE AVE N
BARTOW FL 33830
LARRY BENNETT
VICE PRESIDENT
978 WHISPER COVE
WINTER HAVEN FL 33880
JAMES JABLONSKY
SECRETARY
11330 DEMILLE RD
POLK CITY FL 33868
PAUL WOMBLE
TREASURER
5303 ENGLISH DR
LAKELAND FL 33812
FASSHAUER KIRK
DIRECTOR
PO BOX 1559
BARTOW FL 33831
| Organization’s website | |
|---|---|
| Organization’s email | ROSALALONDE@POLK-COUNTY.NET |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 2/24/2015 |
| Organization Incorporation State | FL |
| 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: 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 | 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 | |
| Signature Title | |
| Signature Date |
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