FORM 1023-EZ for CRISIS DOCTOR AND ASSOCIATES

Field Data
EIN 81-3873527
Case Number EO-2019238-000669
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CRISIS DOCTOR AND ASSOCIATES
Organization’s Mailing Address 214 REMINGTON DRIVE
City DOTHAN
State AL
ZIP 36303-8910
Accounting period End 12
Primary contact name JAMES WHITEHEAD CPA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TIM FAULK
CHAIRMAN
214 REMINGTON DRIVE
DOTHAN AL 36303-8910

Officer/Director/Trustee Two

KEVIN FAULK
VICE CHAIR
214 REMINGTON DRIVE
DOTHAN AL 36303-8910

Officer/Director/Trustee Three

DON RAWLINGSON
SECRETARY/TREASURER
214 REMINGTON DRIVE
DOTHAN AL 36303-8910

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/15/15
Organization Incorporation State AL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F60 - Counseling, Support Groups
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name TIM FAULK
Signature Title CHAIRMAN
Signature Date 8/23/19

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