FORM 1023-EZ for MEDICINE X FOUNDATION

Field Data
EIN 83-3357110
Case Number EO-2019059-000490
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MEDICINE X FOUNDATION
Organization’s Mailing Address 22809 PACIFIC COAST HIGHWAY NUM 215
City MALIBU
State CA
ZIP 90265
Accounting period End 12
Primary contact name FIONA DOOLAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KIM CHILMAN-BLAIR
PRESIDENT
22809 PACIFIC COAST HIGHWAY NUM 215
MALIBU CA 90265

Officer/Director/Trustee Two

FIONA DOOLAN
DIRECTOR
6350 TRANCAS CANYON RD
MALIBU CA 90265

Officer/Director/Trustee Three

MARG GLASGOW
SECRETARY
54 ROGERS RD
CARMEL IN 46032

Officer/Director/Trustee Four

MIKE FRAMPTON
CFO
3952 RIDGMONT DR
MALIBU CA 90265

Organization’s website
Organization’s email FIONADOOLAN@MEDICINEX.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/29/19
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E60 - Health Support Services
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 KIM CHILMAN-BLAIR
Signature Title PRESIDENT
Signature Date 2/26/19

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