FORM 1023-EZ for LAMOURELLE BRAIN INSTITUTE

Field Data
EIN 86-2626388
Case Number EO-2021097-001494
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LAMOURELLE BRAIN INSTITUTE
Organization’s Mailing Address 1777 MITCHELL AVENUE UNIT 61
City TUSTIN
State CA
ZIP 92780
Accounting period End 12
Primary contact name CHANTAL LAMOURELLE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CHANTAL LAMOURELLE
PRESIDENT
1777 MITCHELL AVENUE 61
TUSTIN CA 92780

Officer/Director/Trustee Two

JAXON SIMS
TREASURER
1777 MITCHELL AVENUE 61
TUSTIN CA 92780

Officer/Director/Trustee Three

MAGALI LAMOURELLE
VICE PRESIDENT
11 MINFORD CIRCLE
LADERA RANCH CA 92688

Officer/Director/Trustee Four

REGINA LAMOURELLE
BOARD PRESIDENT
22186 WESTCLIFF DRIVE
MISSION VIEJO CA 92692

Organization’s website lamourellebraininstitute@
Organization’s email lamourellebraininstitute@gmail.com
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/24/2020
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B99 - Education N.E.C.
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
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 CHANTAL LAMOURELLE
Signature Title PRESIDENT
Signature Date 3/16/2021

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