FORM 1023-EZ for HMONG MEDICAL ASSOCIATION INC

Field Data
EIN 32-0580646
Case Number EO-2018318-000374
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HMONG MEDICAL ASSOCIATION INC
Organization’s Mailing Address 604 BIELENBERG DRIVE SUITE 250 RM A
City WOODBURY
State MN
ZIP 55125
Accounting period End 12
Primary contact name MAI SEE MOUA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

UMENG THAO
CHAIR
12416 MEADOW BLUFF TRAIL
AFTON MN 55001-9212

Officer/Director/Trustee Two

STEVEN MOUACHEUPAO
VICECHAIR
5514-144TH CT NW
RAMSEY MN 55303-5717

Officer/Director/Trustee Three

YER XIONG
SECRETARY
7030 MID OAKS AVENUE NORTH
STILLWATER MN 55082-5244

Officer/Director/Trustee Four

SHOUA KALUGDAN
TREASURER
6479 HEDGECOFT AVENUE SOUTH
COTTAGE GROVE MN 55016-5501

Officer/Director/Trustee Five

MAI MOUA
BOARD MEMBER
1770 BLUEWATER LANE
WOODBURY MN 55129-6236

Organization’s website HTTP://HMONGMEDICALASSOCIATION.ORG/
Organization’s email HMONGMEDICAL@HMONGMEDICALASSOCIATION.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/1/18
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E03 - Professional Societies, Associations
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 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 MAI MOUA
Signature Title BOARD MEMBER
Signature Date 11/12/18

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