FORM 1023-EZ for KC EPILEPSY MENTAL HEALTH

Field Data
EIN 82-2068612
Case Number EO-2017258-000351
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name KC EPILEPSY MENTAL HEALTH
Organization’s Mailing Address 1010 BAYCREST LANE APT E
City HARBOR
State CA
ZIP 90710
Accounting period End 12
Primary contact name KADEISHA CORBIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KADEISHA CORBIN
PRESIDENT
1010 BAYCREST LANE APT E
HARBOR CA 90710

Officer/Director/Trustee Two

MARLON FRIEND
VICE PRESIDENT
2511 SANTA ANA BLVD
LOS ANGELES CA 90059

Officer/Director/Trustee Three

VERNETTE MORGAN
SECRETARY
625 S SAN PEDRO ST APT 303
LOS ANGELES CA 90014

Officer/Director/Trustee Four

MICHAEL POPE
TREASURER
61216 S WILTON PLACE
LOS ANGELES CA 90047

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/20/2017
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P80 - Services to Promote the Independence of Specific Populations
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
Signature Title
Signature Date

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