FORM 1023-EZ for NATIONAL ALLIANCE ON MENTAL ILLNESS#NAME?

Field Data
EIN 26-1299856
Case Number EO-2018292-000158
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name NATIONAL ALLIANCE ON MENTAL ILLNESS#NAME?
Organization’s Mailing Address PO BOX 3174
City PINEVILLE
State LA
ZIP 71361-3174
Accounting period End 12
Primary contact name RITA D MARTIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RITA D MARTIN
PRESIDENT
259 PROSPECT RD
DRY PRONG LA 71423-3479

Officer/Director/Trustee Two

VICTOR B DENNIS JR
TREASURER
257 STILLEY ROAD
PINEVILLE LA 71360-5934

Officer/Director/Trustee Three

RONALD A DEJOIE
VICE-PRESIDENT
3023 STIMSON ST
ALEXANDRIA LA 71301

Officer/Director/Trustee Four

LINDA D MCMAHON
SECRETARY
4207 PECAN DRIVE
ALEXANDRIA LA 71302

Officer/Director/Trustee Five

PAULA JOHNSON
MEMBER
2495 SHREVEPORT HWY
PINEVILLE LA 71360

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/23/08
Organization Incorporation State LA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F80 - Mental Health Association, 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 Yes
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 RITA D MARTIN
Signature Title PRESIDENT
Signature Date 10/17/18

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