FORM 1023-EZ for MEDLEGAL REPORTS

Field Data
EIN 83-4380674
Case Number EO-2019133-000597
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MEDLEGAL REPORTS
Organization’s Mailing Address 4641 POST ST BOX 4530
City EL DORADO HILLS
State CA
ZIP 95762
Accounting period End 12
Primary contact name ROBERT DICKMAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ROBERT DICKMAN
PRESIDENT/DIRECTOR
4641 POST ST BOX 4530
EL DORADO HILLS CA 95762

Officer/Director/Trustee Two

DANIEL BARLOW
DIRECTOR
4641 POST ST BOX 4530
EL DORADO HILLS CA 95762

Officer/Director/Trustee Three

MARCUS SLATEN
DIRECTOR
4641 POST ST BOX 4530
EL DORADO HILLS CA 95762

Officer/Director/Trustee Four

MICHELLE DICKMAN
TREASURER/SECRETARY
4641 POST ST BOX 4530
EL DORADO HILLS CA 95762

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/22/19
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E70 - Public Health Program (Includes General Health and Wellness Promotion Services)
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 ROBERT DICKMAN
Signature Title PRESIDENT/DIRECTOR
Signature Date 5/10/19

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