FORM 1023-EZ for KCNMA1 CHANNELOPATHY INTERNATIONALADVOCACY FOUNDATION INC

Field Data
EIN 83-4532605
Case Number EO-2019169-000432
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name KCNMA1 CHANNELOPATHY INTERNATIONALADVOCACY FOUNDATION INC
Organization’s Mailing Address 425 E 63RD ST APT E12F
City NEW YORK
State NY
ZIP 10065
Accounting period End 12
Primary contact name SOTIRIOS KEROS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SOTIRIOS KEROS
PRESIDENT
425 E 63RD ST APT E12F
NEW YORK NY 10065

Officer/Director/Trustee Two

ANDREA MEREDITH
VICE PRESIDENT
655 W BALTIMORE ST BRB 5-002
BALTIMORE MD 21201

Officer/Director/Trustee Three

MICHAEL KRUER
BOARD MEMBER
1919 E THOMAS RD NUM 3332
PHOENIX AZ 85016

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/29/19
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G80 - Specifically Named Diseases
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
Scientific: Yes
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 SOTIRIOS KEROS
Signature Title PRESIDENT
Signature Date 6/14/19
EIN 83-4532605
Case Number EO-2019169-000432
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name KCNMA1 CHANNELOPATHY INTERNATIONAL ADVOCACY FOUNDATION INC
Organization’s Mailing Address 425 E 63RD ST APT E12F
City NEW YORK
State NY
ZIP 10065
Accounting period End 12
Primary contact name SOTIRIOS KEROS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SOTIRIOS KEROS
PRESIDENT
425 E 63RD ST APT E12F
NEW YORK NY 10065

Officer/Director/Trustee Two

ANDREA MEREDITH
VICE PRESIDENT
655 W BALTIMORE ST BRB 5-002
BALTIMORE MD 21201

Officer/Director/Trustee Three

MICHAEL KRUER
BOARD MEMBER
1919 E THOMAS RD NUM 3332
PHOENIX AZ 85016

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/29/19
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G80 - Specifically Named Diseases
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
Scientific: Yes
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 SOTIRIOS KEROS
Signature Title PRESIDENT
Signature Date 6/14/19

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