FORM 1023-EZ for AMERICA PHYSICIAN ASSOCIATES
| Field | Data |
|---|---|
| EIN | 82-3531109 |
| Case Number | EO-2018080-000107 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | AMERICA PHYSICIAN ASSOCIATES |
| Organization’s Mailing Address | 1208 ELGIN STREET |
| City | SAN LEANDRO |
| State | CA |
| ZIP | 94578-2323 |
| Accounting period End | 4 |
| Primary contact name | KATHERINE T MILLER |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
KATHERINE MILLER
FOUNDER
1208 ELGIN STREET
SAN LEANDRO CA 94578
Officer/Director/Trustee Two
JELANI JOHNSON-BRISCOE
CFO
1076 CAROL LN APT 141
LAFAYETTE CA 94549
Officer/Director/Trustee Three
SAIDEH FARAHMANDRIA
DEPUTY SECRETARY
PO BOX 661592
SACRAMENTO CA 95866
Officer/Director/Trustee Four
JUSTIN CHUNG
DIRECTOR
8462 WHITAKER ST APT 6
BUENA PARK CA 90612
Officer/Director/Trustee Five
RAJESH RAMASWARMY
DIRECTOR
NA
NA CA 0
| Organization’s website | WWW.USAPHA.ORG |
|---|---|
| Organization’s email | AMERICAPHA@GMAIL.COM |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 9/29/17 |
| Organization Incorporation State | CA |
| 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: No Religious: No Educational: Yes Scientific: No Literary: No Public Safety: No Amateur Sports: No Cruelty Prevention: No |
| Qualify For Exemption | No |
| Legislation influence | Yes |
| Compensation of Officer director trustee | Yes |
| 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 | Yes |
| Correctness Declaration | Yes |
| Signature Name | KATHERINE MILLER |
| Signature Title | FOUNDER |
| Signature Date | 3/19/18 |
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