FORM 1023-EZ for SUICIDE PREVENTION AND INTERDICTIONNETWORK

Field Data
EIN 47-5648838
Case Number EO-2016022-000181
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SUICIDE PREVENTION AND INTERDICTIONNETWORK
Organization’s Mailing Address 311 WILLOW ST APT 203
City FORT COLLINS
State CO
ZIP 80524
Accounting period End 12
Primary contact name JOHNATHON MELAMED
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JOHNATHON MELAMED
PRESIDENT, DIRECTOR
311 WILLOW ST APT 203
FORT COLLINS CO 80524

Officer/Director/Trustee Two

SETH PIER
SECRETARY, DIRECTOR
90 MERCER AVE
ROCHESTER NY 14606

Officer/Director/Trustee Three

RON OFERRALL
TREASURER, DIRECTOR
16315 GRIFFIN DRIVE E
PUYALLUP WA 98375

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/14/2015
Organization Incorporation State CO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
Organization’s purpose Charitable: Yes
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
Signature Title
Signature Date

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