FORM 1023-EZ for FFOUNDATION FOR PROFESSIONAL DEVELOPMENT OF INDEPENDENT MEDICAL EXAMI

Field Data
EIN 85-3139218
Case Number EO-2020277-000008
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name FFOUNDATION FOR PROFESSIONAL DEVELOPMENT OF INDEPENDENT MEDICAL EXAMI
Organization’s Mailing Address 6470 MERRICK CREEK RD
City HUNTINGTON
State WV
ZIP 25702
Accounting period End 12
Primary contact name MOHAMMED RANAVAYA MD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RAJ KHANNA
PRESIDENT
1616 13TH AVENUE
HUNTINGTON WV 25701

Officer/Director/Trustee Two

ALEX AMBROZ
SECRETARY
PO BOX 823
MARTINSBURG WV 25402

Officer/Director/Trustee Three

RAMANATHAN PADMANABAN
TREASURER
112 EAST RIDGE ROAD
CHARLESTON WV 25314

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/23/2020
Organization Incorporation State WV
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: 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 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 ALEX AMBROZ
Signature Title SECRETARY
Signature Date 9/30/2020

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