FORM 1023-EZ for DELIVERANCE FREE CLINIC FOUNDATION
| Field | Data |
|---|---|
| EIN | 83-1897630 |
| Case Number | EO-2018260-000385 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | DELIVERANCE FREE CLINIC FOUNDATION |
| Organization’s Mailing Address | 660 SW MILITARY DR SUITE E |
| City | SAN ANTONIO |
| State | TX |
| ZIP | 78221 |
| Accounting period End | 12 |
| Primary contact name | HUSSEIN MUSA |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
HUSSEIN MUSA
PRESIDENT/ BOARD MEMBER
660 SW MILITARY DR SUITE E
SAN ANTONIO TX 78221
Officer/Director/Trustee Two
ADETOUN ABISOGUN MUSA
TREASURER/ BOARD MEMBER
660 SW MILITARY DR SUITE E
SAN ANTONIO TX 78221
Officer/Director/Trustee Three
JACOB CARRILLO
SECRETARY/ BOARD MEMBER
660 SW MILITARY DR SUITE E
SAN ANTONIO TX 78221
| Organization’s website | WWW.DFREECLINIC.COM |
|---|---|
| Organization’s email | INFO@DFREECLINIC.COM |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 9/13/18 |
| Organization Incorporation State | TX |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | G90 - Medical Disciplines |
| Organization’s purpose | Charitable: Yes Religious: Yes 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 | Yes |
| 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 | HUSSEIN MUSA |
| Signature Title | PRESIDENT/ BOARD MEMBER |
| Signature Date | 9/13/18 |
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