FORM 1023-EZ for THE ARKANSAS PHYSICIANS ORAL HISTORY PROJECT

Field Data
EIN 82-1322700
Case Number EO-2017130-000422
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name THE ARKANSAS PHYSICIANS ORAL HISTORY PROJECT
Organization’s Mailing Address 290 RESTFUL RIDGE CIRCLE
City HOT SPRINGS
State AR
ZIP 71913
Accounting period End 12
Primary contact name SAM TAGGART
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SAM TAGGART
DIRECTOR
290 RESTFUL RIDGE CIRCLE
HOT SPRINGS AR 71913

Officer/Director/Trustee Two

ANNETTE ENDERLIN
DIRECTOR
290 RESTFUL RIDGE CIRCLE
HOT SPRINGS AR 71913

Officer/Director/Trustee Three

JP BELL
DIRECTOR
417 SUTTON
FAYETTEVILLE AR 72701

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/14/2017
Organization Incorporation State AR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code V20 - Social Science Institutes, Services
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 Yes
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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