FORM 1023-EZ for CARDIOINTERCONNECT

Field Data
EIN 81-3804944
Case Number EO-2021196-000365
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CARDIOINTERCONNECT
Organization’s Mailing Address 2423 S SUMMIT CIR
City SALT LAKE CITY
State UT
ZIP 84109
Accounting period End 5
Primary contact name SHREEKANTH KARWANDE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DAVID AFFLECK
DIRECTOR
1160 E 3900 S STE3500
SALT LAKE CITY UT 84124

Officer/Director/Trustee Two

J KENT THORNE
DIRECTOR
1160 E 3900S STE3500
SALT LAKE CITY UT 84124

Officer/Director/Trustee Three

SHREEKANTH KARWANDE
DIRECTOR
2423 S SUMMITCIR
SALT LAKE CITY UT 84109

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/15/2017
Organization Incorporation State UT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E60 - Health Support Services
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 Yes
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 Yes
Correctness Declaration Yes
Signature Name SHREEKANTH KARWANDE
Signature Title DIRECTOR
Signature Date 7/13/2021
EIN 81-3804944
Case Number EO-2016301-000149
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CARDIOINTERCONNECT
Organization’s Mailing Address 2423 SOUTH SUMMIT CIRCLE
City SALT LAKE CITY
State UT
ZIP 84109
Accounting period End 12
Primary contact name SHREEKANTH KARWANDE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHREEKANTH KARWANDE
DIRECTOR
2423 SOUTH SUMMIT CIRCLE
SALT LAKE CITY UT 84109

Officer/Director/Trustee Two

DAVID AFFLECK
DIRECTOR
1160 EAST 3900 SOUTH STE 3500
SALT LAKE CITY UT 84124

Officer/Director/Trustee Three

KENT THORNE
DIRECTOR
1160 EAST 3900 SOUTH STE 3500
SALT LAKE CITY UT 84124

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/13/2016
Organization Incorporation State UT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Q30 - International Development, Relief Services
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 Yes
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
Signature Title
Signature Date

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