FORM 1023-EZ for LIBERATE LEARNING INSTITUTE

Field Data
EIN 81-1786736
Case Number EO-2016098-000178
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LIBERATE LEARNING INSTITUTE
Organization’s Mailing Address 3833 MCREE AVE
City SAINT LOUIS
State MO
ZIP 63110
Accounting period End 6
Primary contact name JON-PIERRE MITCHOM
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JON-PIERRE MITCHOM
PRESIDENT
3833 MCREE AVE
SAINT LOUIS MO 63110

Officer/Director/Trustee Two

CHARLOTTE IJEI
BOARD MEMBER
3833 MCREE AVE
SAINT LOUIS MO 63110

Officer/Director/Trustee Three

DARRYL MCADOO
BOARD MEMBER
3255 S SEPULVEDA BLVD 302
LOS ANGELES CA 90034

Officer/Director/Trustee Four

MOYENDA ANWISYE
BOARD MEMBER
PO BOX 29033
SAINT LOUIS MO 63112

Officer/Director/Trustee Five

APRIL LOMAX
BOARD MEMBER
1521 ENGLISH PINE LANE
OFALLON IL 62269

Organization’s website
Organization’s email JPMITCHOM@ICLOUD.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/7/2016
Organization Incorporation State MO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F30 - Mental Health Treatment - Multipurpose and N.E.C.
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 Yes
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More Yes
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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