FORM 1023-EZ for CONSORTIUM OF INDIANA MEDICAL LABORATORY EDUCATORS

Field Data
EIN 82-4362086
Case Number EO-2018045-000112
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CONSORTIUM OF INDIANA MEDICAL LABORATORY EDUCATORS
Organization’s Mailing Address 350 W 11TH ST RM6002F
City INDIANAPOLIS
State IN
ZIP 46202
Accounting period End 7
Primary contact name NICHOLAS BREHL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

NICHOLAS BREHL
TREASURER
350 W 11TH ST RM 6002F
INDIANAPOLIS IN 46202

Officer/Director/Trustee Two

CARLA CLEM
PRESIDENT
350 W 11TH ST RM 6002E
INDIANAPOLIS IN 46202

Officer/Director/Trustee Three

DEANNE MAXWELL
SECRETARY
8111 S EMERSON AVE
INDIANAPOLIS IN 46237

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/9/18
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B01 - Alliance/Advocacy Organizations
Organization’s purpose Charitable: No
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 Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name NICHOLAS BREHL
Signature Title TREASURER
Signature Date 2/12/18

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