FORM 1023-EZ for PATIENTS WITH PRE-EXISTING CONDITIONS
| Field | Data |
|---|---|
| EIN | 81-4495641 |
| Case Number | EO-2017038-000011 |
| Form 1023-EZ version | 62014 |
| Eligibility Worksheet | 1 |
| Organization Name | PATIENTS WITH PRE-EXISTING CONDITIONS |
| Organization’s Mailing Address | 3141 COLLEGE AVENUE |
| City | BEKELEY |
| State | CA |
| ZIP | 94705 |
| Accounting period End | 12 |
| Primary contact name | HEATHER SAPP |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
JOHN HOLLAND
PRES., SEC., CFO, DIRECTOR
3141 COLLEGE AVENUE
BERKELEY CA 94705
Officer/Director/Trustee Two
RAY WILCOX
DIRECTOR
2235 MARKET STREET
SAN FRANCISCO CA 94114
Officer/Director/Trustee Three
EVAN DEERFIELD
DIRECTOR
2665 GENEVA AVENUE APT 409
DALY CITY CA 94014
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 11/21/2016 |
| Organization Incorporation State | CA |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | P80 - Services to Promote the Independence of Specific Populations |
| 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 | |
| Signature Title | |
| Signature Date |
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