FORM 1023-EZ for WESTERN NEW YORK PHYSICIAN ASSISTANT ASSOCIATION

Field Data
EIN 52-2366535
Case Number EO-2014328-000245
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name WESTERN NEW YORK PHYSICIAN ASSISTANT ASSOCIATION
Organization’s Mailing Address 471
City WILLIAMSVILLE
State NY
ZIP 14231
Accounting period End 12
Primary contact name VIRGINIA KAUFMAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

VIRGINIA KAUFMAN
PA-C
51 DOGWOOD ROAD
WILLIAMSVILLE NY 14221

Officer/Director/Trustee Two

LAURA PFALZGRAF
PA-C
129 HARRIS COURT
CHEEKTOWAGA NY 14225

Officer/Director/Trustee Three

REBECCA BUTTACCIO
PA-C
127 TILLINGHAST PLACE
BUFFALO NY 14216

Officer/Director/Trustee Four

CAROL CALHOUN
PA-C
55 WYNNGATE LANE
WILLIAMSVILLE NY 14221

Organization’s website WWW.WNYPAA.ORG
Organization’s email PRESIDENT@WNYPAA.ORG
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/28/2012
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B03 - 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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