FORM 1023-EZ for GREEN MOUNTAIN CRITICAL INCIDENT STRESS MANAGEMENT TEAM INC

Field Data
EIN 47-5627449
Case Number EO-2016027-000218
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name GREEN MOUNTAIN CRITICAL INCIDENT STRESS MANAGEMENT TEAM INC
Organization’s Mailing Address 540 ROUTE 131
City ASCUTNEY
State VT
ZIP 05030
Accounting period End 10
Primary contact name KELLY MURPHY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JAMES MCCARRAGHER
PRESIDENT
25 UNDERHILL ROAD
MERIDEN NH 03770

Officer/Director/Trustee Two

LAWRENCE CLARK
VICE PRESIDENT
PO BOX 425
BELLOWS FALLS VT 05101

Officer/Director/Trustee Three

MARGARET FISH
SECRETARY
243 SHERWOOD FOREST
LONDONDERRY VT 05148

Officer/Director/Trustee Four

KELLY MURPHY
TREASURER
249 ROUTE 12
ASCUTNEY VT 05030

Officer/Director/Trustee Five

WILLIAM ELWELL
DIRECTOR
37 NORTH STREET
BRISTOL VT 05443

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/7/2015
Organization Incorporation State VT
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: 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 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 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
Signature Title
Signature Date

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