FORM 1023-EZ for LIBERIAN ADVANCED PRACTICE PROVIDERNETWORK PROFESSIONAL ASSOCIATION
| Field | Data |
|---|---|
| EIN | 84-4854820 |
| Case Number | EO-2021083-000696 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | LIBERIAN ADVANCED PRACTICE PROVIDERNETWORK PROFESSIONAL ASSOCIATION |
| Organization’s Mailing Address | 6199 147TH AVENUE NW |
| City | RAMSEY |
| State | MN |
| ZIP | 55303 |
| Accounting period End | 12 |
| Primary contact name | WALAKEWON BLEGAY |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
RACHEL SUMO
PRESIDENT
6199 147TH AVENUE NW
RAMSEY MN 55303
Officer/Director/Trustee Two
SUSANNAH KETTER
SECRETARY
3549 BAILEY RIDGE DRIVE
WOODBERRY MN 55125
Officer/Director/Trustee Three
ORETHA SOGBIE
VICE PRESIDENT
1611 ALSTON ROAD
TOWSON MD 21204
Officer/Director/Trustee Four
DR VICKY BRIGGS
TREASURER
5468 VILLAGECREEK PARKWAY NORTH
BROOKLYN PARK MN 55443
Officer/Director/Trustee Five
DR STELLA JEFFERIES
BOARD OF DIRECTORS
11130 NEW HAMPSHIRE AVENUE
SILVER SPRING MD 20904
| Organization’s website | |
|---|---|
| Organization’s email | LIBAPPN@GMAIL.COM |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 2/24/2020 |
| Organization Incorporation State | MN |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | E60 - Health Support Services |
| 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 | Yes |
| 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 | RACHEL SUMO |
| Signature Title | PRESIDENT |
| Signature Date | 11/16/2020 |
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