FORM 1023-EZ for EMERGENCY PEDIATRIC INTERDISCIPLINARY CARE CONFERENCE

Field Data
EIN 47-3528573
Case Number EO-2015302-000222
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name EMERGENCY PEDIATRIC INTERDISCIPLINARY CARE CONFERENCE
Organization’s Mailing Address 5971 S MOON DESERT DRIVE
City TUCSON
State AZ
ZIP 85748
Accounting period End 12
Primary contact name KEVIN BURKHART
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

KEVIN BURKHART
DIRECTOR
5971 S MOON DESERT DRIVE
TUCSON AZ 85747

Officer/Director/Trustee Two

MARY MCDONALD
DIRECTOR
3643 N BANNER MINE DR
TUCSON AZ 85745

Officer/Director/Trustee Three

DALE WOOLRIDGE
DIRECTOR
3051 W NEOSHA ST
TUCSON AZ 85745

Officer/Director/Trustee Four

AARON LEETCH
DIRECTOR
4612 W LINDENTHAL LN
TUCSON AZ 85742

Organization’s website HTTP://WWW.EPICCAZ.ORG
Organization’s email KBURKHART@EPICCAZ.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/10/2015
Organization Incorporation State AZ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code M41 - First Aid Training, Services
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: Yes
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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