FORM 1023-EZ for LOVE POTION COLLECTIVE

Field Data
EIN 47-1940758
Case Number EO-2014316-000140
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LOVE POTION COLLECTIVE
Organization’s Mailing Address 1960 MANDELA PKWY BAY 2
City OAKLAND
State CA
ZIP 94607-1647
Accounting period End 12
Primary contact name WILLIAM FULLER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

WILLIAM FULLER
CHIEF EXECUTIVE OFFICER
1620 CHESTNUT ST
OAKLAND CA 94607-2876

Officer/Director/Trustee Two

RENEE GREEN
CHIEF OPERATING OFFICER
1219 12TH ST
OAKLAND CA 94607-2201

Officer/Director/Trustee Three

SHAWN SILVERMAN
OFFICER
219 SIXTH ST
SAN FRANCISCO CA 94103-4011

Officer/Director/Trustee Four

DAVID LEBLANC
OFFICER
3355 BRITTAN AVE UNIT 10
SAN CARLOS CA 94070-3430

Officer/Director/Trustee Five

CORMAC RUSSELL
OFFICER
10452 MERRIMAN ROAD
CUPERTINO CA 95014-2638

Organization’s website HTTP://WWW.LOVEPOTIONCOLLECTIVE.ORG/
Organization’s email HELLO@LOVEPOTIONCOLLECTIVE.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/1/2014
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A20 - Arts, Cultural Organizations - Multipurpose
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 Yes
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
Signature Title
Signature Date

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