FORM 1023-EZ for RURAL HEALTH SCHOLAR PIPELINE
| Field | Data |
|---|---|
| EIN | 85-4303185 |
| Case Number | EO-2021118-000275 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | RURAL HEALTH SCHOLAR PIPELINE |
| Organization’s Mailing Address | 4038 OLD DAIRY ROAD SUITE 101 |
| City | KETCHIKAN |
| State | AK |
| ZIP | 99901 |
| Accounting period End | 12 |
| Primary contact name | CHARLES JOSE |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
CHARLES JOSE
MD MPH
4038 OLD DAIRY ROAD SUITE 101
KETCHIKAN AK 99901
Officer/Director/Trustee Two
PETER RICE
MD
1395 POND REEF ROAD
KETCHIKAN AK 99901
Officer/Director/Trustee Three
NISHA SINGH
MS
94-46 116TH STREET
RICHMOND HILL NY 11419
| Organization’s website | WWW.CHARLIEJOSE.COM |
|---|---|
| Organization’s email | RURALHSP@GMAIL.COM |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 4/14/2021 |
| Organization Incorporation State | AK |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | B82 - Scholarships, Student Financial Aid Services, Awards |
| Organization’s purpose | Charitable: Yes 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 | 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 | CHARLES JOSE |
| Signature Title | MD MPH |
| Signature Date | 4/26/2021 |
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