FORM 1023-EZ for PATIENTS ADVOCACY COALITION

Field Data
EIN 83-1761828
Case Number EO-2018247-000524
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PATIENTS ADVOCACY COALITION
Organization’s Mailing Address 3511 WESTFIELD DRIVE
City BRANDON
State FL
ZIP 33511
Accounting period End 12
Primary contact name MORIAH BARNHART
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MORIAH BARNHART
CEO
3511 WESTFIELD DRIVE
BRANDON FL 33511

Officer/Director/Trustee Two

CARRIE MCCLAIN
COO
3RD ST
NEPTUNE BEACH FL 32266

Officer/Director/Trustee Three

JACEL DELGADILLO
P
9310 W FLAGLER ST APT 104
MIAMI FL 33174

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/30/18
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B01 - Alliance/Advocacy Organizations
Organization’s purpose Charitable: Yes
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 Yes
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity Yes
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 MORIAH BARNHART
Signature Title CEO
Signature Date 8/30/18

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