FORM 1023-EZ for MISSISSIPPI PODIATRIC MEDICAL ASSOCIATION

Field Data
EIN 83-2577265
Case Number EO-2018330-000110
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MISSISSIPPI PODIATRIC MEDICAL ASSOCIATION
Organization’s Mailing Address PO BOX 296
City MADISON
State MS
ZIP 39130
Accounting period End 12
Primary contact name STEPHANIE THOMAS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

STEPHANIE THOMAS
PRESIDENT
705 HWY 80
CLINTON MS 39056

Officer/Director/Trustee Two

RICKY ROACH
TREASURER
999 N HALSTEAD ROAD
OCEAN SPRINGS MS 39564

Officer/Director/Trustee Three

CARLA MARTIN
VICE PRESIDENT
9065 SANDIDGE CENTER COVE
OLIVE BRANCH MS 38654

Officer/Director/Trustee Four

RENITA PARKER
SECRETARY
1434 EAST CENTRAL AVENUE
WIGGINS MS 39577

Organization’s website WWW.MSPMA.NET
Organization’s email EXECUTIVEDIRECTOR@MSPMA.NET
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/10/18
Organization Incorporation State MS
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E03 - Professional Societies, Associations
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name STEPHANIE THOMAS
Signature Title PRESIDENT
Signature Date 11/23/18

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