FORM 1023-EZ for COMMUNITY CARDIOVASCULAR INITIATIVE
| Field | Data |
|---|---|
| EIN | 47-4222432 |
| Case Number | EO-2019220-000206 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | COMMUNITY CARDIOVASCULAR INITIATIVE |
| Organization’s Mailing Address | 7452 OGONTZ AVENUE |
| City | PHILADELPHIA |
| State | PA |
| ZIP | 19138 |
| Accounting period End | 12 |
| Primary contact name | ANDREA CLEARKIN |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
SANU CORRIELUS
PRESIDENT
628 MANOR ROAD
PENN VALLEY PA 19072
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 7/10/15 |
| Organization Incorporation State | PA |
| 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: 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 | Yes |
| One Third Support Gifts | No |
| Benefit of College | No |
| Private Foundation 508(e) | No |
| Seeking Retroactive Reinstatement | Yes |
| Seeking Section 7 Reinstatement | No |
| Correctness Declaration | Yes |
| Signature Name | SANU CORRIELUS |
| Signature Title | PRESIDENT |
| Signature Date | 8/6/19 |
| EIN | 47-4222432 |
| Case Number | EO-2015327-000362 |
| Form 1023-EZ version | 62014 |
| Eligibility Worksheet | 1 |
| Organization Name | COMMUNITY CARDIOVASCULAR INITIATIVE |
| Organization’s Mailing Address | 628 MANOR RD |
| City | PENN VALLEY |
| State | PA |
| ZIP | 19072 |
| Accounting period End | 12 |
| Primary contact name | KEVIN L VALENTINE |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $400.00 |
Officer/Director/Trustee One
SANUL CORRIELUS
EXECUTIVE DIRECTOR
628 MANOR RD
PENN VALLEY PA 19072
Officer/Director/Trustee Two
THIERRY MOMPLAISIR
BOARD MEMBER
541 MATSONFORD ROAD
VILLANOVA PA 19085
Officer/Director/Trustee Three
DEAN PARKER
BOARD MEMBER
900 WEST SPROUL ROAD SUITE 104
SPRINGFIELD PA 19064
Officer/Director/Trustee Four
DIEM JONES
BOARD MEMBER
3720 SPRUCE STREET SUITE 442
PHILADELPHIA PA 19104
Officer/Director/Trustee Five
PATRICK OATES
BOARD MEMBER
5070 PARKSIDE AVENUE SUITE 3200
PHILADELPHIA PA 19131
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 7/10/2015 |
| Organization Incorporation State | PA |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | G01 - Alliance/Advocacy Organizations |
| Organization’s purpose | Charitable: Yes 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 | Yes |
| Donation of funds | Yes |
| 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 | |
| Signature Title | |
| Signature Date |
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