FORM 1023-EZ for SEDGWICK COUNTY OSETOPATHIC MEDICALSOCIETY

Field Data
EIN 26-2369079
Case Number EO-2017118-000170
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SEDGWICK COUNTY OSETOPATHIC MEDICALSOCIETY
Organization’s Mailing Address 301 N MAIN SUITE 1300
City WICHITA
State KS
ZIP 67202
Accounting period End 12
Primary contact name PATRICIA M DENGLER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ANGELA MOORE DO
PRESIDENT
2131 N RIDGE RD STE 101
WICHITA KS 67212

Officer/Director/Trustee Two

WILLIAM SIMON DO
VICE PRESIDENT
2131 N RIDGE RD STE 101
W KS 67212

Officer/Director/Trustee Three

THOMAS NIENKE DO
SECRETARY-TREASURER
1923 N WEBB RD
WICHITA KS 67206

Organization’s website N/A
Organization’s email PDENGLER@GH-KS.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/12/2017
Organization Incorporation State KS
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E03 - 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 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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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