FORM 1023-EZ for PATIENT NAVIGATION RESOURCES

Field Data
EIN 81-5017117
Case Number EO-2017083-000218
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PATIENT NAVIGATION RESOURCES
Organization’s Mailing Address 2775 KURTZ STREET SUITE 6
City SAN DIEGO
State CA
ZIP 92110
Accounting period End 12
Primary contact name JULIA BUSCH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JULIA BUSCH
CEO/SECRETARY
2775 KURTZ STREET SUITE 6
SAN DIEGO CA 92110

Officer/Director/Trustee Two

JAMES ALLEN
CFO
1147 CASA BONITA WAY
VISTA CA 92081

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/23/2017
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E01 - Alliance/Advocacy Organizations
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
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 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
Signature Title
Signature Date

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