FORM 1023-EZ for NATIONAL INSTITUTE FOR PEER SUPPORT

Field Data
EIN 20-1398650
Case Number EO-2017229-000368
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name NATIONAL INSTITUTE FOR PEER SUPPORT
Organization’s Mailing Address 9211 TOPEKA ST
City BETHESDA
State MD
ZIP 20817
Accounting period End 12
Primary contact name JIM DRISCOLL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JAMES DRISCOLL
TREASAURER
9211 TOPEKA ST
BETHESDA MD 20817

Officer/Director/Trustee Two

JOE STURDIVANT
PRESIDENT
4324 DEER VALLEY WAY
OCEANSIDE CA 92057

Officer/Director/Trustee Three

DAVE WELLS
SECRETARY
2022 E RADCLIFFE
TEMPE AZ 85283

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/15/2004
Organization Incorporation State DE
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W70 - Leadership Development
Organization’s purpose Charitable: No
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement Yes
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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