FORM 1023-EZ for KANSAS CITY SOCIETY OF PALLIATIVE MEDICINE

Field Data
EIN 47-4364833
Case Number EO-2015294-000154
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name KANSAS CITY SOCIETY OF PALLIATIVE MEDICINE
Organization’s Mailing Address 6400 DEARBORN DRIVE
City MISSION
State KS
ZIP 66202-4241
Accounting period End 12
Primary contact name PAMELA HARRIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

PAMELA HARRIS
PRESIDENT
6400 DEARBORN DRIVE
MISSION KS 66202-4241

Officer/Director/Trustee Two

CATHERINE POWERS
SECRETARY
6400 DEARBORN DRIVE
MISSION KS 66202-4241

Officer/Director/Trustee Three

RICHARD BUTIN
TREASURER
6400 DEARBORN DRIVE
MISSION KS 66202-4241

Officer/Director/Trustee Four

BETH THOMAS
BOARD MEMBER-AT-LARGE
6400 DEARBORN DRIVE
MISSION KS 66202-4241

Organization’s website KCSPM.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/25/2015
Organization Incorporation State KS
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E03 - Professional Societies, Associations
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
Signature Title
Signature Date

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