FORM 1023-EZ for GOOD SAMARITANS ULTRASOUND

Field Data
EIN 81-2080357
Case Number EO-2016102-000138
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name GOOD SAMARITANS ULTRASOUND
Organization’s Mailing Address 23 VALLEY STREET
City BELLEVILLE
State NJ
ZIP 07109
Accounting period End 12
Primary contact name RAMY GHALY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

RAMY GHALY
PRESIDENT
23 VALLEY STREET
BELLEVILLE NJ 07109

Officer/Director/Trustee Two

LAILA GHALY
OFFICER
77 WEST 33RD STREET
BAYONNE NJ 07002

Officer/Director/Trustee Three

KRISTIE ABDELAMALAK
SECRETARY
23 VALLEY STREET
BELLEVILLE NJ 07109

Organization’s website
Organization’s email RAMY.GHALY3@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/4/2016
Organization Incorporation State NJ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E32 - Ambulatory Health Center, Community Clinic
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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