FORM 1023-EZ for AMERICAN SOCIETY OF OPTOMETRIC SURGEONS LTD
| Field | Data |
|---|---|
| EIN | 82-5328539 |
| Case Number | EO-2018128-000742 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | AMERICAN SOCIETY OF OPTOMETRIC SURGEONS LTD |
| Organization’s Mailing Address | 2625 CAMBRIDGE CIRCLE |
| City | TAHLEQUAH |
| State | OK |
| ZIP | 74464 |
| Accounting period End | 12 |
| Primary contact name | RICHARD CASTILLO |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
RICHARD CASTILLO
DIRECTOR/TRUSTEE
2625 CAMBRIDGE CIRCLE
TAHLEQUAH OK 74464
Officer/Director/Trustee Two
CLIFF CAUDILL OD
TREASURER/DIRECTOR
147 SYCAMORE STREET
PIKEVILLE KY 41501
Officer/Director/Trustee Three
ALISSA COYNE OD
SECRETARY/DIRECTOR
1200 W GODFREY AVENUE
PHILADELPHIA PA 19141
Officer/Director/Trustee Four
ELIZABETH WYLES OD
DIRECTOR OF COLLABORATIVE INFRASTRU
3241 SOUTH MICHIGAN AVE
CHICAGO IL 60616
Officer/Director/Trustee Five
JAMES HUNTER OD
VICE PRESIDENT
800 E ATWATER AVE
BLOOMINGTON IN 47405
| Organization’s website | WWW.OPTOMETRICSURGERYORG |
|---|---|
| Organization’s email | RCDO@ME.COM |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 4/24/18 |
| Organization Incorporation State | OK |
| 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: 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 | 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 | RICHARD CASTILLO |
| Signature Title | DIRECTOR/TRUSTEE |
| Signature Date | 5/2/18 |
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