FORM 1023-EZ for AMEDICAUSA INC

Field Data
EIN 81-0842688
Case Number EO-2016004-000305
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name AMEDICAUSA INC
Organization’s Mailing Address 619 LEE PLACE
City FREDERICK
State MD
ZIP 21702
Accounting period End 12
Primary contact name NEALE BROWN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

NEALE BROWN
PRESIDENT
619 LEE PLACE
FREDERICK MD 21702

Officer/Director/Trustee Two

SILVANA AYUSO
EXECUTIVE VICE PRESIDENT
19 AVENIDA 7-21 ZONA 14
GUATEMALA CITY, GUAT

Officer/Director/Trustee Three

PETER OYKHMAN
VICE PRESIDENT, BUSINESS AFFAIRS
5 S MARKET ST SUITE 3
FREDERICK MD 21701

Officer/Director/Trustee Four

GABRIELA BROWN
SECRETARY TREASURER
619 LEE PLACE
FREDERICK MD 21702

Officer/Director/Trustee Five

TRACEY ELIZALDE
VICE PRESIDENT, CLINICAL MEDICINE
9 ST PAUL ST SUITE 2
BOONSBORO MD 21713

Organization’s website HTTP://WWW.AMEDICAUSA.ORG
Organization’s email NEALE.BROWN@AMEDICAUSA.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/16/2015
Organization Incorporation State MD
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code M20 - Disaster Preparedness and Relief 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 No
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 Yes
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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