FORM 1023-EZ for HAMPTON ROADS MEDICAL SCHOLARS INSTITUTE

Field Data
EIN 84-2749529
Case Number EO-2020295-000406
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HAMPTON ROADS MEDICAL SCHOLARS INSTITUTE
Organization’s Mailing Address PO BOX 9426
City CHESAPEAKE
State VA
ZIP 23321
Accounting period End 12
Primary contact name STAFFORD BROWN JR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

STAFFORD BROWN JR
PRESIDENT/DIRECTOR
1816 CHAZ CT
CHESAPEAKE VA 23321

Officer/Director/Trustee Two

MARK INNIS
TREASURER
873 REDLEAFE CIRCLE
CHESAPEAKE VA 23320

Officer/Director/Trustee Three

ROSALIND BROWN
SECRETARY
1816 CHAZ CT
CHESAPEAKE VA 23321

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/6/2019
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
Organization’s purpose Charitable: No
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 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 No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name STAFFORD BROWN JR
Signature Title PRESIDENT/DIRECTOR
Signature Date 10/13/2020

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