FORM 1023-EZ for RURAL MEDICAL DATA CENTERS FOR EXCELLENCE

Field Data
EIN 61-1910368
Case Number EO-2019035-000918
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name RURAL MEDICAL DATA CENTERS FOR EXCELLENCE
Organization’s Mailing Address 1233 REGATTA ST 204
City FAYETTEVILLE
State NC
ZIP 28301-3736
Accounting period End 7
Primary contact name JASON BUTLER MD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOSEPH ROBERTS JR
PRESIDENT
302 4TH ST
PEMBROKE NC 28372-9639

Organization’s website WWW.RMDCE.ORG
Organization’s email MAIL@RMDCE.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/10/18
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E02 - Management & Technical Assistance
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
Literary: No
Public Safety: Yes
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 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 JOSEPH ROBERTS JR
Signature Title PRESIDENT
Signature Date 1/14/19

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