FORM 1023-EZ for ANESTHESIA ALCHEMY INCORPORATED

Field Data
EIN 85-4282286
Case Number EO-2021033-000134
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ANESTHESIA ALCHEMY INCORPORATED
Organization’s Mailing Address 8835 SW107TH AVE STE 347
City MIAMI
State FL
ZIP 33143
Accounting period End 12
Primary contact name CHARNELLE LEWIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CHARNELLE LEWIS
DIRECTOR, PRESIDENT
8835 SW107TH AVE STE 347
MIAMI FL 33137

Officer/Director/Trustee Two

BYRON ANDERSON
DIRECTOR, VICE PRESIDENT
8835 SW107TH AVE STE 347
MIAMI FL 33137

Officer/Director/Trustee Three

TERRICA HARRIS
DIRECTOR, TREASURER
8835 SW107TH AVE STE 347
MIAMI FL 33143

Organization’s website WWW.ANESTHESIAALCHEMY.COM
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/11/2020
Organization Incorporation State NV
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E02 - Management & Technical Assistance
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 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 No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name CHARNELLE LEWIS
Signature Title DIRECTOR, PRESIDENT
Signature Date 12/16/2020

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