FORM 1023-EZ for TRI-COUNTY CRISIS INTERVENTION TEAM
| Field | Data |
|---|---|
| EIN | 82-4186420 |
| Case Number | EO-2018219-000167 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | TRI-COUNTY CRISIS INTERVENTION TEAM |
| Organization’s Mailing Address | 706 CURTIS STREET |
| City | MASON |
| State | MI |
| ZIP | 48854 |
| Accounting period End | 12 |
| Primary contact name | DARIN SOUTHWORTH |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
ERICANNE SPENCE
CHAIRWOMAN
706 CURTIS STREET
MASON MI 48854
Officer/Director/Trustee Two
TERESA RITSEMA
CO-CHAIRWOMAN
5514 KINSEL HWY
CHARLOTTE MI 48813
Officer/Director/Trustee Three
MELISSA MISNER
SECRETARY
CEI-CMH 812 EAST JOLLY RD
LANSING MI 48910
Officer/Director/Trustee Four
DARIN SOUTHWORTH
TREASURER
ICSO 630 N CEDAR
MASON MI 48854
| Organization’s website | HTTP://WWW.TRICOUNTYCIT.COM/ |
|---|---|
| Organization’s email | TRICOUNTYCIT@GMAIL.COM |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 2/28/18 |
| Organization Incorporation State | MI |
| 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: No 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 | DARIN SOUTHWORTH |
| Signature Title | TREASURER |
| Signature Date | 8/5/18 |
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