FORM 1023-EZ for NATIONAL ALLIANCE ON MENTAL ILLNESSCABARRUS COUNTY

Field Data
EIN 56-2126684
Case Number EO-2018008-000238
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name NATIONAL ALLIANCE ON MENTAL ILLNESSCABARRUS COUNTY
Organization’s Mailing Address PO BOX 1795
City CONCORD
State NC
ZIP 28026-1795
Accounting period End 3
Primary contact name ISMAEL CARRASQUILLO
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ISMAEL CARRASQUILLO
PRESIDENT
2525 OLD PLANK ROAD
KANNAPOLIS NC 28083

Officer/Director/Trustee Two

NELSON KIRK
VICE-PRESIDENT
764 HATHCOCK GLEN DRIVE
OAKBORO NC 28129-7748

Officer/Director/Trustee Three

LANIE HAYWARD
TREASURER
1202 PRESSLEY DOWNS DR
CONCORD NC 28025-7260

Officer/Director/Trustee Four

SHERRY DELISO
SECRETARY
6129 THE MEADOWS LN
HARRISBURG NC 28075

Organization’s website NAMICABARRUS
Organization’s email ISCARR44@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/24/00
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B01 - Alliance/Advocacy Organizations
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 Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name ISMAEL CARRASQUILLO
Signature Title PRESIDENT
Signature Date 1/5/18
EIN 56-2126684
Case Number EO-2018136-000486
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name NATIONAL ALLIANCE ON MENTAL ILLNESSCABARRUS COUNTY
Organization’s Mailing Address 2525 OLD PLANK ROAD
City KANNAPOLIS
State NC
ZIP 28083
Accounting period End 3
Primary contact name ISMAEL CARRASQUILLO
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ISMAEL CARRASQUILLO
PRESIDENT
2525 OLD PLANK ROAD
KANNAPOLIS NC 28083

Officer/Director/Trustee Two

NELSON KIRK
VICE-PRESIDENT
764 HATHCOCK GLEN DRIVE
Oakboro NC 28129

Officer/Director/Trustee Three

LANIE HAYWARD
TREASURER
1202 PRESSLEY DOWNS DR
CONCORD NC 28025

Officer/Director/Trustee Four

SHERRY DELISO
SECRETARY
6129 THE MEADOWS LN
HARRISBURG NC 28075

Organization’s website NAMICABARRUS
Organization’s email ISCARR44@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/24/00
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B01 - Alliance/Advocacy Organizations
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 Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name ISMAEL CARRASQUILLO
Signature Title PRESIDENT
Signature Date 5/14/18

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