| Field | Data |
|---|---|
| EIN | 47-2081045 |
| Case Number | EO-2015049-000047 |
| Form 1023-EZ version | 62014 |
| Eligibility Worksheet | 1 |
| Organization Name | CONEJO CONCUSSION INSTITUTE |
| Organization’s Mailing Address | 4165 E THOUSAND OAKS BLVD SUITE 150 |
| City | WESTLAKE VILLAGE |
| State | CA |
| ZIP | 91362 |
| Accounting period End | 12 |
| Primary contact name | SCOTT BLATT |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $400.00 |
SCOTT BLATT
PRESIDENT, CHAIR
4165 THOUSAND OAKS BLVD SUITE 150
WESTLAKE VILLAGE CA 91362
MEGAN ACKERMAN
SECRETARY
1835 AVENDA DE LAS FLORES
THOUSAND OAKS CA 91362
PATRICK HARDIN
VICE PRESIDENT, TREASURER
1835 AVENDA DE LAS FLORES
THOUSAND OAKS CA 91362
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 8/28/2014 |
| Organization Incorporation State | CA |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | G48 - Brain Disorders |
| Organization’s purpose | Charitable: No Religious: No Educational: No Scientific: Yes 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 | Yes |
| 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 | |
| Signature Title | |
| Signature Date |
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