FORM 1023-EZ for COUPLES TLC COUNSELING INC

Field Data
EIN 85-3246966
Case Number EO-2021064-001429
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name COUPLES TLC COUNSELING INC
Organization’s Mailing Address 2501 E CHAPMAN AVE SUITE 106
City FULLERTON
State CA
ZIP 92831
Accounting period End 12
Primary contact name LOLA GERSHFELD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JACK GERSHFELD
CEO
2501 E CHAPMAN AVE SUITE 106
FULLERTON CA 92831

Officer/Director/Trustee Two

LOLA GERSHFELD
CFO
2501 E CHAPMAN AVE SUITE 106
FULLERGON CA 92831

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/13/2020
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F32 - Community Mental Health Center
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 LOLA GERSHFELD
Signature Title CFO
Signature Date 1/11/2021

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