FORM 1023-EZ for HEALTHCARE TECHNOLOGY MANAGEMENT ASSOCIATION - NORTH TEXAAS

Field Data
EIN 82-3172841
Case Number EO-2017321-000340
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HEALTHCARE TECHNOLOGY MANAGEMENT ASSOCIATION - NORTH TEXAAS
Organization’s Mailing Address 3922 JASMINE FOX LANE
City ARLINGTON
State TX
ZIP 76005-4512
Accounting period End 12
Primary contact name DARREN B MOORE - AUTHORTIZED REPRES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DAVID BRAEUTIGAM
PRESIDENT
3922 JASMINE FOX LANE
ARLINGTON TX 76005-4512

Officer/Director/Trustee Two

ANDREA BRAINARD
VICE PRESIDENT
3411 CLIFF OAKS DRIVE
CORINTH TX 76210-1802

Officer/Director/Trustee Three

DANIEL IRVING
SECRETARY
505 MEDFORD LANE
ALLEN TX 75013

Officer/Director/Trustee Four

GARRETT SEELEY
TREASURER
3801 CAMPUS DRIVE
WACO TX 76705-1607

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/20/2017
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B99 - Education N.E.C.
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
Scientific: Yes
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 No
One Third Support Gifts Yes
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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