FORM 1023-EZ for GLOMERULAR DISEASE STUDY AND TRIALCONSORTIUM
| Field | Data |
|---|---|
| EIN | 86-2088226 |
| Case Number | EO-2021089-001118 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | GLOMERULAR DISEASE STUDY AND TRIALCONSORTIUM |
| Organization’s Mailing Address | 667 SEQUOIA VALLEY RD |
| City | MILL VALLEY |
| State | CA |
| ZIP | 94941 |
| Accounting period End | 12 |
| Primary contact name | LAURA SOLOMON ESQ |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
DR ALI POYAN MEHR
PRESIDENT, DIRECTOR
667 SEQUOIA VALLEY RD
MILL VALLEY CA 94941
Officer/Director/Trustee Two
JOSH TARNOFF
SECRETARY, DIRECTOR
150 S WARNER ROAD SUITE 402
KING OF PRUSSIA PA 19406
Officer/Director/Trustee Three
OLGA YURCHENKO
TREASURER, DIRECTOR
101 WINTHROP RD APT 2
BROOKLINE MA 02445
Officer/Director/Trustee Four
DR MARTIN POLLACK
DIRECTOR
DIV OF NEPHROLOGY 99 BROOKLINE AVE
BOSTON MA 02215
Officer/Director/Trustee Five
DR MARIA ANSARI
DIRECTOR
35 ST JOSEPHS
SAN FRANCISCO CA 94115
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 2/3/2021 |
| Organization Incorporation State | PA |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | H20 - Birth Defects, Genetic Diseases Research |
| 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 | Yes |
| Conducting Activities Outside of United States | Yes |
| Financial transactions with officers | Yes |
| 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 | DR ALI POYAN MEHR |
| Signature Title | PRESIDENT, DIRECTOR |
| Signature Date | 2/16/2021 |
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