FORM 1023-EZ for DIABETES ALLIANCE NETWORK

Field Data
EIN 87-1365936
Case Number EO-2021200-000360
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name DIABETES ALLIANCE NETWORK
Organization’s Mailing Address PO BOX 110161
City NAPLES
State FL
ZIP 34108
Accounting period End 12
Primary contact name JOSEPH BALAVAGE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOSEPH BALAVAGE
PRESIDENT
28026 SOSTA LN UNIT 1
BONITA SPRINGS FL 34135

Officer/Director/Trustee Two

PAUL THEIN
SECRETARY
8016 PRINCETON DRIVE
NAPLES FL 34104

Officer/Director/Trustee Three

MICHAEL HALLER
DIRECTOR
1600 ARCHER ROAD
GAINESVILLE FL 32610

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/12/2018
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P01 - Alliance/Advocacy Organizations
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name JOSEPH BALAVAGE
Signature Title PRESIDENT
Signature Date 7/15/2021

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