FORM 1023-EZ for CONVERSION THERAPY DROPOUT NETWORK
| Field | Data |
|---|---|
| EIN | 83-3971026 |
| Case Number | EO-2019100-000057 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | CONVERSION THERAPY DROPOUT NETWORK |
| Organization’s Mailing Address | 45 PALOMA AVE APT 6 |
| City | VENICE |
| State | CA |
| ZIP | 90291 |
| Accounting period End | 12 |
| Primary contact name | CURTIS GALLOWAY |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
CURTIS GALLOWAY
PRESIDENT
45 PALOMA AVE APT6
VENICE CA 90291
Officer/Director/Trustee Two
ERIK RIVERA
TREASURER
9852 W KATELLA AVE NO 358
ANAHEIM CA 92804
Officer/Director/Trustee Three
CHRISTOPHER THOMASON
SECRETARY
PO BOX
LA CRESCENTA CA 91224
Officer/Director/Trustee Four
CHARLES CHAN-MASSEY
BOARD MEMBER
34 RIVER ROCK COURT
AZUSA CA 91702
Officer/Director/Trustee Five
LANDON BROWNFIELD
BOARD MEMBER
5387 REBER PL
SAINT LOUIS MO 63139
| Organization’s website | |
|---|---|
| Organization’s email | CONVERSIONTHERAPYDROPOUT@GMAIL.COM |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 3/14/19 |
| Organization Incorporation State | CA |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | W01 - Alliance/Advocacy Organizations |
| 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 | CURTIS GALLOWAY |
| Signature Title | PRESIDENT |
| Signature Date | 4/7/19 |
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