FORM 1023-EZ for CLINICAL SCHOLARS PROGRAM ALUMNI ASSOCIATION

Field Data
EIN 82-1308641
Case Number EO-2017142-000532
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CLINICAL SCHOLARS PROGRAM ALUMNI ASSOCIATION
Organization’s Mailing Address 700 N PENNOCK STREET UNIT 102
City PHILADELPHIA
State PA
ZIP 19130-1736
Accounting period End 12
Primary contact name MICHAEL G KNIGHT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SREYRAM KUY
CO-CHAIR
2350 SUMMERLEAF CIRCLE
BATON ROUGE LA 70816-8377

Officer/Director/Trustee Two

STEPHEN PATRICK
CO-CHAIR
9428 CHENOWETH PL
BRENTWOOD TN 37027-8701

Officer/Director/Trustee Three

MICHAEL KNIGHT
TREASURER
1440 MOUNT VERNON STREET APT 701
PHILADELPHIA PA 19130-3477

Officer/Director/Trustee Four

KYMBERLY GONZALEZ
SECRETARY
700 N PENNOCK STREET UNIT 102
PHILADELPHIA PA 19130-1736

Officer/Director/Trustee Five

JOSHUA CHODOSH
VICE-CHAIR
310 EAST 53RD STREET APT 9A
NEW YORK NY 10022-5242

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/26/2017
Organization Incorporation State PA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Y03 - 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 No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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