FORM 1023-EZ for ORCHID MENTAL HEALTH LEGAL ADVOCACYOF COLORADO INC

Field Data
EIN 46-3620543
Case Number EO-2016340-000461
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ORCHID MENTAL HEALTH LEGAL ADVOCACYOF COLORADO INC
Organization’s Mailing Address 3644 EAST FREMONT PLACE
City CENTENNIAL
State CO
ZIP 80122
Accounting period End 4
Primary contact name VALERIE CORZINE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

VALERIE CORZINE
EXECUTIVE DIRECTOR
3644 EAST FREMONT PLACE
CENTENNIAL CO 80122

Officer/Director/Trustee Two

DOCTOR HENRY JACKSON JUNIOR
BOARD MEMBER
890 AURARIA PARKWAY
DENVER CO 80204

Officer/Director/Trustee Three

BARBARA STEPHENSON
BOARD MEMBER
3470 SOUTH POPLAR NUMBER 406
DENVER CO 80224

Officer/Director/Trustee Four

ADAM KIPPES
BOARD MEMBER (HOMELESS)
3644 EAST FREMONT PLACE
CENTENNIAL CO 80122

Organization’s website WWW.ORCHIDADVOCACY.ORG
Organization’s email VALERIECORZINE@HOTMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/9/2013
Organization Incorporation State CO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code R20 - Civil Rights, Advocacy for Specific Groups
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 Yes
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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