FORM 1023-EZ for TOTAL BRAIN COACHING
| Field | Data |
|---|---|
| EIN | 84-2110143 |
| Case Number | EO-2019224-000593 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | TOTAL BRAIN COACHING |
| Organization’s Mailing Address | 603 PLEASANT PLAIN RD |
| City | FAIRFIELD |
| State | IA |
| ZIP | 52556 |
| Accounting period End | 12 |
| Primary contact name | ROBERT KEITH WALLACE |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
ROBERT THEODORE WALLACE
PRESIDENT AND DIRECTOR
603 PLEASANT PLAIN RD
FAIRFIELD IA 52556
Officer/Director/Trustee Two
ROBERT KEITH WALLACE
CHAIRPERSON AND TREASUER
1008 HEAVENLY LN
FAIRFIELD IA 52556
Officer/Director/Trustee Three
JOEL SILVER
DIRECTOR
PO BOX 321
FAIRFILD IA 52556
Officer/Director/Trustee Four
DOUG WADSWORTH
DIRECTOR
3208 WEST TYLER AVE
FAIRFIELD IA 52556
Officer/Director/Trustee Five
EVERETT DAY
DIRECTOR
2040 SAPPHIRE LANE
FAIRFIELD IA 52556
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 6/6/19 |
| Organization Incorporation State | IA |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | W70 - Leadership Development |
| 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 | ROBERT KEITH WALLACE |
| Signature Title | CHAIRPERSON AND TREASUER |
| Signature Date | 8/10/19 |
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