FORM 1023-EZ for OZARKS AREA CRISIS INTERVENTION TEAM

Field Data
EIN 84-2164000
Case Number EO-2020241-000069
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name OZARKS AREA CRISIS INTERVENTION TEAM
Organization’s Mailing Address 1443 N ROBBERSON
City SPRINGFIELD
State MO
ZIP 65802
Accounting period End 12
Primary contact name JOSIAH DAUGHERTY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOSIAH DAUGHERTY
CO-CHAIR/CHAIR OF FINANCE
715 W CENTER CIRCLE
NIXA MO 65714

Officer/Director/Trustee Two

JODY AUSTIN
CO -CHAIR
227 E CHESTNUT EXPRESSWAY
SPRINGFIELD MO 65802

Officer/Director/Trustee Three

RACHEL HUDSON
SECRETARY
1300 E BRADFORD PARKWAY
SPRINGFIELD MO 65804

Officer/Director/Trustee Four

KOLBY HELMS
CHAIR OF TRAINING
321 E CHESTNUT EXPRESSWAY
SPRINGFIELD MO 65802

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/20/2019
Organization Incorporation State MO
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 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 JOSIAH DAUGHERTY
Signature Title CO-CHAIR/CHAIR OF FINANCE
Signature Date 8/26/2020

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