FORM 1023-EZ for NORTHWEST CHAPTER OF THE MICHIGAN ASSOCIATION FOR INFANT MENTAL HEALTH
| Field | Data |
|---|---|
| EIN | 84-3295276 |
| Case Number | EO-2020092-000037 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | NORTHWEST CHAPTER OF THE MICHIGAN ASSOCIATION FOR INFANT MENTAL HEALTH |
| Organization’s Mailing Address | 1011 LAKE RIDGE DR UNIT 305 |
| City | TRAVERSE CITY |
| State | MI |
| ZIP | 49684-6625 |
| Accounting period End | 12 |
| Primary contact name | MICHAEL ACOSTA |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
MICHAEL ACOSTA
TREASURER
1011 LAKE RIDGE DR UNIT 305
TRAVERSE CITY MI 49684
Officer/Director/Trustee Two
EMILY KOHLER
PRESIDENT
11145 FORT RD
SUTTONS BAY MI 49682
Officer/Director/Trustee Three
SHANNON OLSHOVE
SECRETARY
TBA ISD 800 PARSONS RD
TRAVERSE CITY MI 49684
Officer/Director/Trustee Four
AMANDA STOWE
BOARD MEMBER
7401 E DUCK LAKE RD A
LAKE LEELANAU MI 49653
Officer/Director/Trustee Five
TRICIA DENTON
BOARD MEMEBR
25 S LAKE LEELANAU DR
LAKE LEELANAU MI 49653
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 10/7/2019 |
| Organization Incorporation State | MI |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | F01 - Alliance/Advocacy Organizations |
| Organization’s purpose | Charitable: No Religious: No Educational: Yes Scientific: No Literary: No Public Safety: No Amateur Sports: No Cruelty Prevention: Yes |
| 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 | MICHAEL ACOSTA |
| Signature Title | TREASURER |
| Signature Date | 3/29/2020 |
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