America's Frontline Doctors 1023 Tax-Exempt Application

Form 1023 ApplicationforRecognitionofExemption OMBNo. 1545-0047 Under ton rememtpesenCode [— ot fe DomotecsodisecatymbensonsformasKmbemadetic. | omen sant InternalRevereService Gotowwwirs.gow/Form1023for instructionsandthelatest information. Seoonorpithisgueton. EEEeeeeeeeeSetoee3705,youtciesreedresponsesiintheeoughtmssyonltesthhethridprocs mo oa SS FSSE TE TRE SPEECHFOUNDATION EE ey SHEVA ROADNO 19 werses State 9 ZipCode+4 ForeignProvince (or State). ForeignPostalCode ei2Employer identification Number a Person to Contact ifMore InformationisNeeded(officer, Eon sma pr momsssie 5 ContactTelephoneNumber 6 FaxNumber (optional) TTT UserfeeSubmitted sms om + OmniWebsvathamesmalinsissyafer,Gers ores Frsthame: SWONE [amomerco [Te CARMANANDCEO Wang Arn 615 WESTVALENGAROADRO 1019) Gon — Sworn zon ToCai eg oRIHT 57 Tite CA ET Te DECOMHEAR MailingAddress: 1645 WESTVALENCIAROADNO109-193 City: TUCSON — eee eons zon ToCaiounFoI 57 E— FistNome: ay [Gofomeianoay |e DIRECTORAND SECRETARY Wingors 1 WEST UABNGARORD 01013) Gi Tucson oo SeoPodnch szonn ToGai eonoT 7 - ame [wore [re ‘State(orProvince): ZipCode(or ForeignPostalCodel: 85746 _ oo Foam: [ome me Maling Address. Ci: - State orProvince): ZipCode (orForeignPostal Code): uteriearner dcr somes ForPaperwork ReductionActNGtice seaTnstradtons. GUNSDTK Fem108 Ge oram