FORM 1023-EZ for DAKOTA ASSOCIATION MEDICAL STAFF SERVICES

Field Data
EIN 84-2613115
Case Number EO-2019234-000192
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name DAKOTA ASSOCIATION MEDICAL STAFF SERVICES
Organization’s Mailing Address 7600 S MINNESOTA AVENUE STE 202
City SIOUX FALLS
State SD
ZIP 57108-2988
Accounting period End 4
Primary contact name KAREN HIRSCH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LAVONNE MCKEE
PRESIDENT
403 LINCOLN CIRCLE
ALCESTER SD 57001-2245

Officer/Director/Trustee Two

AMBER BARRON
PRESIDENT-ELECT
4500 W 69TH STREET
SIOUX FALLS SD 57108-8148

Officer/Director/Trustee Three

KAREN HIRSCH
TREASURER
7600 S MINNESOTA AVE STE 202
SIOUX FALLS SD 57108-2988

Organization’s website HTTPS://DAKOTAMSS.COM/
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/5/19
Organization Incorporation State SD
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B03 - Professional Societies, Associations
Organization’s purpose Charitable: No
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name KAREN HIRSCH
Signature Title TREASURER
Signature Date 8/20/19

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