FORM 1023-EZ for ORIGINS LEARNING COMMUNITY

Field Data
EIN 83-3952220
Case Number EO-2019140-000329
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ORIGINS LEARNING COMMUNITY
Organization’s Mailing Address 4630 CASHEL GLEN DRIVE
City HOUSTON
State TX
ZIP 77069
Accounting period End 3
Primary contact name REGINA E S PUCKETT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CHAO-CHING CHEN
CHAIRPERSON
15814 CLEAR POINT DRIVE
CYPRESS TX 77429

Officer/Director/Trustee Two

AMBER CLEVELAND
SECRETARY
1270 CONRAD SAUER DRIVE SUITE 105
HOUSTON TX 77043

Officer/Director/Trustee Three

NICOLE CATTIN
TREASURER
5507 SLASHWOOD LANE
SPRING TX 77379

Officer/Director/Trustee Four

CHRISTINA JOHNSON
GENERAL BOARD MEMBER
8101 RESEARCH FOREST DRIVE
THE WOODLANDS TX 77382

Officer/Director/Trustee Five

REGINA PUCKETT
EXECUTIVE DIRECTOR
4630 CASHEL GLEN DRIVE
HOUSTON TX 77069

Organization’s website
Organization’s email ORIGINSLEARNINGCOMMUNITY@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/8/19
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B94 - Parent/Teacher Group
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: Yes
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 No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name REGINA PUCKETT
Signature Title EXECUTIVE DIRECTOR
Signature Date 5/17/19

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