FORM 1023-EZ for KNOXVILLE REGION INDIAN ORIGIN PHYSICIANS ASSOCIATION

Field Data
EIN 20-2705411
Case Number EO-2015279-000285
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name KNOXVILLE REGION INDIAN ORIGIN PHYSICIANS ASSOCIATION
Organization’s Mailing Address 6509 VIRGINIA LEE LANE
City KNOXVILLE
State TN
ZIP 37918
Accounting period End 12
Primary contact name VIREN LALKA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

SUDHA NAIR
PRESIDENT
558 WINDHAM HILL ROAD
KNOXVILLE TN 37934

Officer/Director/Trustee Two

BHAVANA VORA
VICE-PRESIDENT
3003 RIVER HAVEN PT
KNOXVILLE TN 37922

Officer/Director/Trustee Three

ANIL HARSH
SECRETARY
11837 ABNERS RIDGE DR
KNOXVILLE TN 37922

Officer/Director/Trustee Four

SRINIVASA CHINTALAPUDI
SECRETARY/TREASURER
6509 VIRGINIA LEE LANE
KNOXVILLE TN 37918

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/24/2005
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A03 - Professional Societies, Associations
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 No
One Third Support Gifts Yes
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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