FORM 1023-EZ for INSTITUTE FOR GLOBAL PERIOPERATIVECARE

Field	Data
EIN	83-3792196
Case Number	EO-2019277-000507
Form 1023-EZ version	12018
Eligibility Worksheet	1
Organization Name	INSTITUTE FOR GLOBAL PERIOPERATIVECARE
Organization’s Mailing Address	313 TIDEWATER DRIVE
City	HAVRE DE GRACE
State	MD
ZIP	21078
Accounting period End	12
Primary contact name	JOHN B SAMPSON
Primary contact phone	[Hidden]
Primary contact phone extension	[Hidden]
Primary contact fax	[Hidden]
User fee submitted	$275.00

Officer/Director/Trustee One

JOHN B SAMPSON
DIRECTOR AND PRESIDENT
313 TIDEWATER DRIVE
HAVRE DE GRACE MD 21078

Officer/Director/Trustee Two

HUMA MALIK
DIRECTOR AND TREASURER
4713 WINDOM PLACE NW
WASHINGTON DC 20016

Officer/Director/Trustee Three

CHERYL JACKSON
SECRETARY
1536 OLD COACH RD
NEWARK DE 19711

Officer/Director/Trustee Four

PROMISE ARIYO
DIRECTOR
2013 HOLLY RIDGE COURT
TIMONIUM MD 21093

Officer/Director/Trustee Five

JAMES BERNSTEIN
DIRECTOR
455 CONNECTICUT AVE NW
WASHINGTON DC 20814

Organization’s website	WWW.GLOBALPERIOPERATIVE.CARE
Organization’s email	JSAMPSO4@JHMI.EDU
Organization Incorporated	Yes
Organization trust	No
Necessary Organizing Documents	Yes
Organization Incorporation Date	12/10/18
Organization Incorporation State	CA
Contains Limitation	Yes
Does not expressly empower	Yes
Contains dissolution	Yes
National Taxonomy of Exempt Entities (NTEE) code	E70 - Public Health Program (Includes General Health and Wellness Promotion Services)
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	Yes
Conducting Activities Outside of United States	Yes
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	JOHN B SAMPSON
Signature Title	DIRECTOR AND PRESIDENT
Signature Date	10/1/19
EIN	83-3792196
Case Number	EO-2019277-000507
Form 1023-EZ version	12018
Eligibility Worksheet	1
Organization Name	INSTITUTE FOR GLOBAL PERIOPERATIVE CARE
Organization’s Mailing Address	313 TIDEWATER DRIVE
City	HAVRE DE GRACE
State	MD
ZIP	21078
Accounting period End	12
Primary contact name	JOHN B SAMPSON
Primary contact phone	[Hidden]
Primary contact phone extension	[Hidden]
Primary contact fax	[Hidden]
User fee submitted	$275.00