FORM 1023-EZ for WEST TENNESSEE CRISIS RESPONSE TEAM

Field Data
EIN 47-4598042
Case Number EO-2015327-000185
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name WEST TENNESSEE CRISIS RESPONSE TEAM
Organization’s Mailing Address 155 NORTH MAIN STREET SUITE 101D
City COLLIERVILLE
State TN
ZIP 38017-2650
Accounting period End 12
Primary contact name JEFFREY HAMSLEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JEFFREY HAMSLEY
PRESIDENT
155 N MAIN ST STE 101D
COLLIERVILLE TN 38017-2650

Officer/Director/Trustee Two

RACHEL TRIGG
SECRETARY/TREASURER
155 N MAIN ST STE 101D
COLLIERVILLE TN 38017-2650

Officer/Director/Trustee Three

KENNETH BROWN
CHAIRPERSON/DIRECTOR
155 N MAIN ST STE 101D
COLLIERVILLE TN 38017-2650

Officer/Director/Trustee Four

MARK BOWMAN
BOARD DIRECTOR
155 N MAIN ST STE 101D
COLLIERVILLE TN 38017-2650

Organization’s website NA
Organization’s email HAMSLEYCONSULTIN@BELLSOUTH.NET
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/14/2014
Organization Incorporation State TN
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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