FORM 1023-EZ for LEBANESE AMERICAN MEDICAL SOCIETY

Field Data
EIN 82-1078443
Case Number EO-2017328-000223
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LEBANESE AMERICAN MEDICAL SOCIETY
Organization’s Mailing Address 4703 WILLIAMSON ST
City DEARBORN
State MI
ZIP 48126
Accounting period End 6
Primary contact name ALI ZABAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KHALIL MEHDI
DIRECTOR
3208 LINDENWOOD DR
DEARBORN MI 48120

Officer/Director/Trustee Two

ALEX ELSABBAGH
DIRECTOR
26411 ANN ARBOR TRAIL
DEARBORN HEIGHTS MI 48127

Officer/Director/Trustee Three

HASSAN DAKROUB
DIRECTOR
22454 MORELY AVE
DEARBORN MI 48124

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/21/2017
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G90 - Medical Disciplines
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
Signature Title
Signature Date

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