FORM 1023-EZ for ARTHRITIS ALLIANCE OF PENNSYLVANIA

Field Data
EIN 81-3910520
Case Number EO-2016302-000261
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ARTHRITIS ALLIANCE OF PENNSYLVANIA
Organization’s Mailing Address 1100 SPRING GARDEN DRIVE SUITE A
City MIDDLETOWN
State PA
ZIP 17057-3230
Accounting period End 12
Primary contact name DOUGLAS KNEPP
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DOUGLAS KNEPP
PRESIDENT/CEO
1100 SPRING GARDEN DRIVE SUITE A
MIDDLETOWN PA 17057-3230

Officer/Director/Trustee Two

JASON KLOCK
TREASURER
1100 SPRING GARDEN DRIVE SUITE A
MIDDLETOWN PA 17057-3230

Officer/Director/Trustee Three

MELODY CONKLIN
VICE PRESIDENT
1100 SPRING GARDEN DRIVE SUITE A
MIDDLETOWN PA 17057-3230

Officer/Director/Trustee Four

JILL SEAMAM
SECRETARY
1100 SPRING GARDEN DRIVE SUITE A
MIDDLETOWN PA 17057-3230

Officer/Director/Trustee Five

CHRISTY FOUST
DIRECTOR
1100 SPRING GARDEN DRIVE SUITE A
MIDDLETOWN PA 17057-3230

Organization’s website WWW.ARTHRITIS-ALLIANCE.ORG
Organization’s email INFO@ARTHRITIS-ALLIANCE.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/24/2016
Organization Incorporation State PA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G51 - Arthritis
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 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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