FORM 1023-EZ for PHYSCIANS FIGHT AGAINST AMPUTATION BYPASS

Field Data
EIN 81-4375521
Case Number EO-2017006-000156
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PHYSCIANS FIGHT AGAINST AMPUTATION BYPASS
Organization’s Mailing Address 1 BROWN ST APT 1321
City PHILADELPHIA
State PA
ZIP 19123-3528
Accounting period End 12
Primary contact name DR SCOTT HOLLANDER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SCOTT HOLLANDER
DIRECTOR
1 BROWN ST APT 1321
PHILADELPHIA PA 19123-3528

Officer/Director/Trustee Two

RODHMER AJDARI
DIRECTOR
1 BROWN ST APT 1321
PHILADELPHIA PA 19123-3528

Officer/Director/Trustee Three

GEOFFREY LEVINE
DIRECTOR
1 BROWN ST APT 1321
PHILADELPHIA PA 19123-3528

Officer/Director/Trustee Four

JACOB FASSMAN
DIRECTOR
1 BROWN ST APT 1321
PHILADELPHIA PA 19123-3528

Officer/Director/Trustee Five

CHRISTINE FASSMAN
DIRECTOR
1 BROWN ST APT 1321
PHILADELPHIA PA 19123-3528

Organization’s website
Organization’s email HOLLAN1702@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/9/2016
Organization Incorporation State NJ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G99 - Diseases, Disorders, Medical Disciplines N.E.C.
Organization’s purpose Charitable: Yes
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 Yes
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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