FORM 1023-EZ for MULTICULTURAL MEDICATION CONSULTATION CLINIC

Field Data
EIN 47-3263497
Case Number EO-2016064-000079
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MULTICULTURAL MEDICATION CONSULTATION CLINIC
Organization’s Mailing Address 9775 LAFORET DR
City EDEN PRAIRIE
State MN
ZIP 55347
Accounting period End 4
Primary contact name LUCY YUN LU
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

YUN LU
PRESIDENT
9775 LAFORET DR
EDEN PRAIRIE MN 55347

Officer/Director/Trustee Two

HELEN CHIANG
TREASURER
201 MCANDREWS RD W APT 317
BURNSVILLE MN 55337

Officer/Director/Trustee Three

TING-TING WU
CLINIC MANAGER
1619 CARLS ST APT 1
LAUDERDALE MN 55108

Officer/Director/Trustee Four

YANG SONG
EDUCATION OUTREACH MANAGER
828 GATEWAY AVE APT 9
CLINTON IA 52732

Officer/Director/Trustee Five

SHIH SHUAN LIN
SECRETARY
5716 BENTON AVE
EDINA MN 55436

Organization’s website
Organization’s email YAOXUEBOSHI@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/17/2014
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: Yes
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 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
Signature Title
Signature Date

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