FORM 1023-EZ for PHYSICIAN ASSISTANTS OF COLOR INC

Field Data
EIN 85-3262220
Case Number EO-2021079-000144
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PHYSICIAN ASSISTANTS OF COLOR INC
Organization’s Mailing Address 575 12TH ROAD SOUTH
City ARLINGTON
State VA
ZIP 22202
Accounting period End 8
Primary contact name SAMORA LUNGU
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JASMINE COFIELD
PRESIDENT
112 WEST YORK AVENUE
FLINT MI 48505

Officer/Director/Trustee Two

SAMORA LUNGU
VICE PRESIDENT
575 12TH ROAD SOUTH APT 430
ARLINGTON VA 22202

Officer/Director/Trustee Three

MENERVA LOBE
SECRETARY
7031 LUSITANO WAY
SPARKS NV 89436

Officer/Director/Trustee Four

MICHELLE MILLER
TREASURER
8139 ASHWOOD POINTE
SAN ANTONIO TX 78254

Officer/Director/Trustee Five

JOE NATHAN ROGERS
DIRECTOR
1221 SOUTH EADS STREET
ARLINGTON VA 22202

Organization’s website PHYSICIANASSISTANTSOFCOLOR.ORG
Organization’s email INFO@PHYSICIANASSISTANTSOFCOLOR.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/25/2020
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B80 - Student Services, Organizations of Students
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 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 SAMORA LUNGU
Signature Title VICE PRESIDENT
Signature Date 1/25/2021

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