FORM 1023-EZ for AMERICAN COLLEGE OF EMERGENCY MEDICINE PHYSICIAN ASSISTANTS

Field Data
EIN 47-4330979
Case Number EO-2016175-000171
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name AMERICAN COLLEGE OF EMERGENCY MEDICINE PHYSICIAN ASSISTANTS
Organization’s Mailing Address 7426 BRETTON OAKS STREET
City LAS VEGAS
State NV
ZIP 89166
Accounting period End 12
Primary contact name PAUL BOTT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

PAUL BOTT
PRESIDENT
7426 BRETTON OAKS STREER
LAS VEGAS NV 89166-5224

Officer/Director/Trustee Two

TIMOTHY BONJOUR
EXECUTIVE DIRECTOR
4118 BIG HORN BEND
SAN ANTONIO TX 78253-5480

Officer/Director/Trustee Three

GEORGE BARBEE
SECRETARY
105 LOCKWOOD COURT
FAYETTEVILLE NC 28303

Officer/Director/Trustee Four

CHRISTOPHER HOWELL
PUBLIC AFFAIRS DIRECTOR
7146 THUNDERING HERD PLACE
DAYTON OH 45415

Officer/Director/Trustee Five

HEATHER BOTT
TREASURER
7426 BRETTON OAKS STREET
LAS VEGAS NV 89166-5224

Organization’s website WWW.ACEMPA.ORG
Organization’s email ACEMPA2015@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/29/2015
Organization Incorporation State NV
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code H03 - Professional Societies, Associations
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
Signature Title
Signature Date

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