FORM 1023-EZ for DERMATOLOGIC SURGERY TRIALS NETWORK

Field Data
EIN 81-2551946
Case Number EO-2016130-000337
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name DERMATOLOGIC SURGERY TRIALS NETWORK
Organization’s Mailing Address 100 E BELLEVUE 16C
City CHICAGO
State IL
ZIP 60611
Accounting period End 6
Primary contact name MURAD ALAM
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MURAD ALAM
PRESIDENT
100 E BELLEVUE 16C
CHICAGO IL 60611

Officer/Director/Trustee Two

SIMON YOO
TREASURER
676 N ST CLAIR STE 1600
CHICAGO IL 60611

Officer/Director/Trustee Three

EMILY POON
DIRECTOR
676 N ST CLAIR STE1600
CHICAGO IL 60611

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/29/2016
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code H03 - 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 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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