FORM 1023-EZ for GLOBAL HEALTH SECURITY AGENDA CONSORTIUM INC

Field Data
EIN 86-2389137
Case Number EO-2021096-001140
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name GLOBAL HEALTH SECURITY AGENDA CONSORTIUM INC
Organization’s Mailing Address 2011 CRYSTAL DRIVE SUITE 1010
City ARLINGTON
State VA
ZIP 22202
Accounting period End 12
Primary contact name SAMANTHA DITTRICH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SAMANTHA DITTRICH
CHAIR, DIRECTOR
2011 CRYSTAL DRIVE SUITE 1010
ARLINGTON VA 22202

Officer/Director/Trustee Two

CHARLES SHARP
DEPUTY CHAIR, DIRECTOR
2011 CRYSTAL DRIVE SUITE 1010
ARLINGTON VA 22202

Officer/Director/Trustee Three

KAVITA BERGER
SECRETARY, DIRECTOR
2011 CRYSTAL DRIVE SUITE 1010
ARLINGTON VA 22202

Officer/Director/Trustee Four

JULIE FISCHER
COMMUNICATIONS COORDINATOR, DIRECTO
2011 CRYSTAL DRIVE SUITE 1010
ARLINGTON VA 22202

Officer/Director/Trustee Five

FALGUNEE PAREKH
TREASURER, DIRECTOR
2011 CRYSTAL DRIVE SUITE 1010
ARLINGTON VA 22202

Organization’s website GHSACNGS.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/6/2020
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Q01 - 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 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 SAMANTHA DITTRICH
Signature Title CHAIR, DIRECTOR
Signature Date 3/14/2021

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