FORM 1023-EZ for BRAVE MIND LIVING

Field Data
EIN 82-4745068
Case Number EO-2018074-000226
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BRAVE MIND LIVING
Organization’s Mailing Address 9868 LAKE HAVEN CIRCLE
City FORT WORTH
State TX
ZIP 76108
Accounting period End 12
Primary contact name NICOLE VIENNEAU
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

NICOLE VIENNEAU
EXECUTIVE DIRECTOR
9868 LAKE HAVEN CIRCLE
FORT WORTH TX 76108

Officer/Director/Trustee Two

PATRICK OCONNOR
VICE PRESIDENT/DIRECTOR
9868 LAKE HAVEN CIR
FORT WORTH TX 76108

Officer/Director/Trustee Three

RENEE BOURGEOIS
SECRETARY/DIRECTOR
5941 FEATHER WIND WAY
FORT WORTH TX 76135

Organization’s website WWW.BRAVEMINDLIVING.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/9/18
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E70 - Public Health Program (Includes General Health and Wellness Promotion Services)
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 NICOLE VIENNEAU
Signature Title EXECUTIVE DIRECTOR
Signature Date 3/13/18

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