FORM 1023-EZ for TRI-STATE FIRST RESPONDER PEER SUPPORT TEAM

Field Data
EIN 86-2073235
Case Number EO-2021090-000649
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name TRI-STATE FIRST RESPONDER PEER SUPPORT TEAM
Organization’s Mailing Address 974 CHESTERTON WAY
City CINCINNATI
State OH
ZIP 45230
Accounting period End 12
Primary contact name AMY FOLEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

AMY FOLEY
VICE PRESIDENT
974 CHESTERTON WAY
CINCINNATI OH 45230

Officer/Director/Trustee Two

ED VON LEHMDEN
PRESIDENT
974 CHESTERTON WAY
CINCINNATI OH 45230

Officer/Director/Trustee Three

TOM CHARLTON
MEDICAL DIRECTOR
974 CHESTERTON WAY
CINCINNATI OH 45230

Officer/Director/Trustee Four

JIM PETRY
FIRE REPRESENTATIVE
974 CHESTERTON WAY
CINCINNATI OH 45230

Officer/Director/Trustee Five

LARRY BENNETT
FIRE REPRESENTATIVE
974 CHESTERTON WAY
CINCINNATI OH 45230

Organization’s website
Organization’s email A.J.FOLEY2013@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/2/2021
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F99 - Mental Health, Crisis Intervention N.E.C.
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 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 AMY FOLEY
Signature Title VICE PRESIDENT
Signature Date 2/19/2021

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