FORM 1023-EZ for SOCIETY OF BLACK PATHOLOGISTS

Field Data
EIN 85-3598796
Case Number EO-2020300-000592
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SOCIETY OF BLACK PATHOLOGISTS
Organization’s Mailing Address 33 WEST MONROE STREET SUITE 1600
City CHICAGO
State IL
ZIP 60603
Accounting period End 6
Primary contact name PAULA COZZI GOEDERT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CARLA ELLIS MD
DIRECTOR
729 W WAVELAND AVENUE UNIT C
CHICAGO IL 60613

Officer/Director/Trustee Two

VALERIE FITZHUGH MD
DIRECTOR
185 SOUTH ORANGE AVENUE MSB C759
NEWARK NJ 07103

Officer/Director/Trustee Three

NICOLE JACKSON MD
DIRECTOR
2630 W EVERGREEN AVE 3W
CHICAGO IL 60622

Officer/Director/Trustee Four

OLU FADARE MD
DIRECTOR
9300 CAMPUS POINT DR SUITE 1-200
LA JOLLA CA 92093

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/14/2020
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code R30 - Intergroup, Race Relations
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 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 VALERIE FITZHUGH MD
Signature Title DIRECTOR
Signature Date 10/23/2020

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