FORM 1023-EZ for WIREGRASS SUICIDE PREVENTION SERVICES

Field Data
EIN 47-3927483
Case Number EO-2017060-000245
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name WIREGRASS SUICIDE PREVENTION SERVICES
Organization’s Mailing Address 4012 WOODBERRY DRIVE
City DOTHAN
State AL
ZIP 36303
Accounting period End 12
Primary contact name ROSE BLAKEY PHILLIPS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ROSE BLAKEY PHILLIPS
DIRECTOR
4012 WOODBERRY DRIVE
DOTHAN AL 36303

Officer/Director/Trustee Two

GLENDA DAVIS
CHAIR
5190 STATE HWY 134 EAST
HEADLAND AL 36345

Officer/Director/Trustee Three

MELISA COPE
MEMBER
250 CHLOE COURT
DOTHAN AL 36303

Officer/Director/Trustee Four

REGGIE RHODES
LEGAL ADVISOR/TREASURER
214 PERRY AVENUE
DOTHAN AL 36303

Officer/Director/Trustee Five

RICK MCCOMMON
MEMBER
1300 MONTEZUMA AVENUE
DOTHAN AL 36303

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/12/2009
Organization Incorporation State AL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F40 - Hot Line, Crisis Intervention Services
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 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 Yes
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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