FORM 1023-EZ for FRONT LINE COVID-19 CRITICAL CARE ALLIANCE INC

Field Data
EIN 85-2270146
Case Number EO-2020233-000276
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name FRONT LINE COVID-19 CRITICAL CARE ALLIANCE INC
Organization’s Mailing Address 6006 N HIGHLANDS AVENUE
City MADISON
State WI
ZIP 53705
Accounting period End 12
Primary contact name KAREN I WU ESQ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PIERRE KORY
CHAIRMAN, DIRECTOR
6006 N HIGHLANDS AVENUE
MADISON WI 53705

Officer/Director/Trustee Two

PAUL MARIK
VICE CHAIR, DIRECTOR
6006 N HIGHLANDS AVENUE
MADISON WI 53705

Officer/Director/Trustee Three

G UMBERTO MEDURI
SECRETARY, DIRECTOR
6006 N HIGHLANDS AVENUE
MADISON WI 53705

Officer/Director/Trustee Four

JOSE IGLESIAS
TREASURER, DIRECTOR
6006 N HIGHLANDS AVENUE
MADISON WI 53705

Officer/Director/Trustee Five

JOSEPH VARON
DIRECTOR
6006 N HIGHLANDS AVENUE
MADISON WI 53705

Organization’s website WWW.COVID19CRITICALCARE.COM
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/22/2020
Organization Incorporation State DE
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E70 - Public Health Program (Includes General Health and Wellness Promotion Services)
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 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 PIERRE KORY
Signature Title CHAIRMAN, DIRECTOR
Signature Date 8/18/2020

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