FORM 1023-EZ for PATIENT EDUCATION MOVEMENT INC

Field Data
EIN 81-5256067
Case Number EO-2019077-000456
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PATIENT EDUCATION MOVEMENT INC
Organization’s Mailing Address 9876 LAS PLAYAS CT
City FORT MYERS
State FL
ZIP 33919
Accounting period End 12
Primary contact name SUZANNE FISCELLA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SUZANNE FISCELLA
PSD
9873 LAS PLAYAS CT
FORT MYERS FL 33919

Officer/Director/Trustee Two

JONATHAN MITCHELL
T
9873 LAS PLAYAS CT
FORT MYERS FL 33919

Officer/Director/Trustee Three

CHRIS LOUTZENHISER
D
9873 LAS PLAYAS CT
FORT MYERS FL 33919

Officer/Director/Trustee Four

DAVID FINDLEY
VP
9873 LAS PLAYAS CT
FORT MYERS FL 33919

Officer/Director/Trustee Five

DENISE PANCYAK
C
9873 LAS PLAYAS CT
FORT MYERS FL 33919

Organization’s website WWW.PATIENTEDUCATIONMOVEMENT.ORG
Organization’s email INFO@PATIENTEDUCATIONMOVEMENT.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/7/17
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B60 - Adult, Continuing Education
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 SUZANNE FISCELLA
Signature Title PSD
Signature Date 3/14/19

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