FORM 1023-EZ for SERVANTS IN MEDICINE INC

Field Data
EIN 82-0984575
Case Number EO-2017184-000050
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SERVANTS IN MEDICINE INC
Organization’s Mailing Address 2715 SUMMER CREEK DRIVE
City GAINESVILLE
State GA
ZIP 30507
Accounting period End 12
Primary contact name NICHOLAS SCHOENMANN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

NICHOLAS SCHOENMANN
DIRECTOR/PRESIDENT
2715 SUMMER CREEK DRIVE
GAINESVILLE GA 30507

Officer/Director/Trustee Two

GABRIEL PAJARES HURTADO
DIRECTOR/SECRETARY
626 TRACE LANE
LAWRENCEVILLE GA 30046

Officer/Director/Trustee Three

BLAKELY HUDSON
DIRECTOR/TREASURER
247 SUNSET DRIVE
ATHENS GA 30606

Organization’s website
Organization’s email SERVANTSINMEDICINE@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/23/2017
Organization Incorporation State GA
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 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 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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