FORM 1023-EZ for AMERICAN SOCIETY OF OPHTHALMIC TRAUMA INC

Field Data
EIN 84-4894791
Case Number EO-2020111-000143
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name AMERICAN SOCIETY OF OPHTHALMIC TRAUMA INC
Organization’s Mailing Address 600 NORTH WOLFE STREET WILMER B29
City BALTIMORE
State MD
ZIP 21287-0005
Accounting period End 6
Primary contact name FASIKA WORETA MD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JAMES AURAN
PRESIDENT
1070 PARK AVENUE APT 15D
NEW YORK NY 10128-1000

Officer/Director/Trustee Two

FASIKA WORETA
VICE PRESIDENT
600 NORTH WOLFE STREET WILMER B29
BALTIMORE MD 21287-0005

Officer/Director/Trustee Three

GRANT JUSTIN
SECRETARY
618 AUTUMN RIDGE ROAD
BOZEMAN MT 59714-9388

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/7/2020
Organization Incorporation State MD
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G03 - Professional Societies, Associations
Organization’s purpose Charitable: No
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 FASIKA WORETA
Signature Title VICE PRESIDENT
Signature Date 4/16/2020

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