FORM 1023-EZ for WILLIAMSON COUNTY MEDICAL SOCIETY ALLIANCE

Field Data
EIN 74-2842510
Case Number EO-2015082-000263
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name WILLIAMSON COUNTY MEDICAL SOCIETY ALLIANCE
Organization’s Mailing Address 2324 CAMINO DEL VERDES
City ROUND ROCK
State TX
ZIP 78681
Accounting period End 12
Primary contact name SHEVAWN WALZEL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MARILYN SIMKIN
PRESIDENT
121 CANYON OAK LOOP
GEORGETOWN TX 78633-2048

Officer/Director/Trustee Two

CHRIS MILLER
SECRETARY
4310 WEST STATE HIGHWAY 29
GEORGETOWN TX 78628-7009

Officer/Director/Trustee Three

SHEVAWN WALZEL
TREASURER
2324 CAMINO DEL VERDES
ROUND ROCK TX 78681-2256

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/12/1999
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T03 - Professional Societies, Associations
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
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 Yes
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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