FORM 1023-EZ for LABMED INC

Field Data
EIN 64-0883735
Case Number EO-2016060-000273
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LABMED INC
Organization’s Mailing Address 3941 LEGACY DRIVE 204 A-115
City PLANO
State TX
ZIP 75023-8331
Accounting period End 12
Primary contact name MARK MUSEKAMP ATTORNEY FOR LABMED
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DIANNE WALSH
PRESIDENT AND DIRECTOR
318 W MINER ST
WEST CHESTER PA 19382-2833

Officer/Director/Trustee Two

LINDA BAGBY
TREASURER AND DIRECTOR
4040 SAN ANTONIO ROAD
YORBA LINDA CA 92886-7815

Officer/Director/Trustee Three

JIM GROENKE
SECRETARY AND DIRECTOR
282 C STREET
REDWOOD CITY CA 94063-1022

Officer/Director/Trustee Four

DONNA HARRISON
VICE PRESIDENT AND DIRECTOR
2825 43RD AVENUE
MERIDIAN MS 39307-4318

Officer/Director/Trustee Five

STEVE COFFARO
DIRECTOR
6582 OASIS DRIVE
LOVELAND OH 45140-5820

Organization’s website WWW.LABMED.ORG
Organization’s email COMMENTS@LABMED.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/27/1996
Organization Incorporation State MS
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D12 - Fund Raising and/or Fund Distribution
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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