FORM 1023-EZ for AMERICAN ASSOCIATION OF MYCOBACTERIAL DISEASES INC

Field Data
EIN 46-4244468
Case Number EO-2018032-000222
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name AMERICAN ASSOCIATION OF MYCOBACTERIAL DISEASES INC
Organization’s Mailing Address 330 INNOVATION BLVD STE 302
City STATE COLLEGE
State PA
ZIP 16803-6611
Accounting period End 12
Primary contact name KENNETH OLSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KENNETH OLSON
DIRECTOR
330 INNOVATION BLVD STE 302
STATE COLLEGE PA 16803-6611

Officer/Director/Trustee Two

DONALD LEIN
DIRECTOR
330 INNOVATION BLVD STE 302
STATE COLLEGE PA 16803-6611

Officer/Director/Trustee Three

VIVEK KAPUR
DIRECTOR
330 INNOVATION BLVD STE 302
STATE COLLEGE PA 16803-6611

Officer/Director/Trustee Four

PAUL COUSSENS
DIRECTOR
330 INNOVATION BLVD STE 302
STATE COLLEGE PA 16803-6611

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/21/13
Organization Incorporation State PA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G05 - Research Institutes and/or Public Policy Analysis
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 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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name KENNETH OLSON
Signature Title DIRECTOR
Signature Date 1/30/18

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