FORM 1023-EZ for CONQUERORS OF LUPUS FOUNDATION

Field Data
EIN 81-2908847
Case Number EO-2016221-000286
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CONQUERORS OF LUPUS FOUNDATION
Organization’s Mailing Address C/O MINDLAB 18075 VENTURA STE 124
City ENCINO
State CA
ZIP 91316
Accounting period End 12
Primary contact name GLENN MILUS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHAMIKA LAWRENCE
PRESIDENT/DIRECTOR
11364 ESTATES CT
RIVERSIDE CA 92503

Officer/Director/Trustee Two

MONIKA KIM NGUYEN
TREASURER/ DIRECTOR
1901 AVE OF THE STARS STE 200
CENTURY CITY CA 90067

Officer/Director/Trustee Three

SUSAN GIBBS
SECRETARY/DIRECTOR
11364 ESTATES CT
RIVERSIDE CA 92503

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/26/2016
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E86 - Patient Services - Entertainment, Recreation
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 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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