FORM 1023-EZ for UAB SCHOOL OF OPTOMETRY ALUMNI ASSOCIATION

Field Data
EIN 63-1271182
Case Number EO-2015083-000028
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name UAB SCHOOL OF OPTOMETRY ALUMNI ASSOCIATION
Organization’s Mailing Address 1716 UNIVERSITY BLVD
City BIRMINGHAM
State AL
ZIP 35294-0010
Accounting period End 12
Primary contact name PEGGY STRIPLIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DOUGLAS CLARK
PRESIDENT
2617 HWY 31 S
PELHAM AL 35124

Officer/Director/Trustee Two

GEORGE EISCHENS
PRESIDENT ELECT
1807 STATION DR SUITE A
PRATTVILLE AL 36066

Officer/Director/Trustee Three

ZACH MCCARTY
SECRETARY TREASURER
7268 JARNIGAN RD SUITE 200
CHATTANOOGA TN 37421

Officer/Director/Trustee Four

BRYAN BOOZER
PAST PRESIDENT
1000 SECOND AVE SW
CULLMAN AL 35055

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/1/1975
Organization Incorporation State AL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B84 - Alumni Associations
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
Signature Title
Signature Date

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