FORM 1023-EZ for ASSOCIATION OF INDEPENDENT CLINICALPRACTICES

Field Data
EIN 85-3726959
Case Number EO-2020317-000452
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ASSOCIATION OF INDEPENDENT CLINICALPRACTICES
Organization’s Mailing Address 3388 W MAIN STREET
City FRISCO
State TX
ZIP 75034
Accounting period End 12
Primary contact name 630-8065453
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CHINENYE DORIS DIKE
MRS.
13307 SEATTLE SLEW STREET
FRISCO TX 75035

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/24/2020
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A03 - Professional Societies, Associations
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 Yes
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 CHINENYE DORIS DIKE
Signature Title MRS.
Signature Date 11/9/2020

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