FORM 1023-EZ for THE LAMPSHADE FOUNDATION

Field Data
EIN 86-3755151
Case Number EO-2021260-000025
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name THE LAMPSHADE FOUNDATION
Organization’s Mailing Address 310 N THAYER ST APT 2
City ANN ARBOR
State MI
ZIP 48104
Accounting period End 12
Primary contact name RICKY HERBERT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RICKY HERBERT
HEADLIGHT
310 N THAYER ST APT 2
ANN ARBOR MI 48104

Officer/Director/Trustee Two

SAMER CHAHINE
HEAD ENGINEER
720 S STATE ST APT 103
ANN ARBOR MI 48104

Officer/Director/Trustee Three

JESSICA BERGERGON
SWEET PEA HEADLIGHT
4640 W BERRY RD
STERLING MI 48659

Organization’s website
Organization’s email LAMPSHADE@EXPRESSYOURMESS.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/10/2021
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A30 - Media, Communications Organizations
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: Yes
Public Safety: No
Amateur Sports: No
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee Yes
Donation of funds Yes
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity Yes
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 RICKY HERBERT
Signature Title HEADLIGHT
Signature Date 6/12/2021

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