FORM 1023-EZ for PANIRA HEALTHCARE CLINIC INC

Field Data
EIN 47-5263276
Case Number EO-2015286-000018
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PANIRA HEALTHCARE CLINIC INC
Organization’s Mailing Address 13384 COVENANT ROAD
City NAPLES
State FL
ZIP 34114
Accounting period End 12
Primary contact name LAWRENCE J EGGER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

LAWRENCE J EGGER
PRESIDENT
13384 COVENANT ROAD
NAPLES FL 34114

Officer/Director/Trustee Two

MARIE G MONGENE-EGGER
VICE PRESIDENT
13384 COVENANT ROAD
NAPLES FL 34114

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/7/2015
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E30 - Health Treatment Facilities, Primarily Outpatient
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 Yes
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
Signature Title
Signature Date

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