2018-02-05T16:49:54-06:00 2016-12-31 GREEN HASSON & JANKS LLP 10990 WILSHIRE BLVD 16th FLOOR LOS ANGELES CA 900243929 990 2016-01-01 475552178 Pacific Neuroscience Institute Foundation PACI 3105827450 11645 Wilshire Boulevard No 600 Los Angeles CA 90025 Daniel F Kelly MD CEO 3105827450 2018-02-01 1 Lizbeth G Nevarez P01399868 3108731600 38.186.35.254 2018-02-01 15:16:15 PS P 6D01638DAE8D868EB136283B9222ABE2A2B9AA10 3768C9BCE607C95689066778B8EBE14D72DD6D37 2016 2021-01-29 14:40:06Z Daniel F Kelly MD 11645 Wilshire Boulevard No 600 Los Angeles CA 90025 749510 0 X www.pacificneuroscienceinstitute.org X 2015 CA To fundamentally advance neuroscience clinical care through novel treatment approaches that optimize brain health and quality of life, to train the next generation of neuroscientists and clinicians, and to educate patients and the community at large on vital neuroscience issues. 4 3 0 0 0 0 0 749455 0 0 0 55 0 0 0 749510 0 5000 0 0 0 0 0 0 50180 0 311031 0 316031 0 433479 0 471330 0 37851 0 433479 X To fundamentally advance neuroscience clinical care through novel treatment approaches that optimize brain health and quality of life, to train the next generation of neuroscientists and clinicians, and to educate patients and the community at large on vital neuroscience issues. 0 0 94589 0 0 Educating and informing the public about new developments in neuroscience research, treatments and clinical trials. 98555 0 0 Production of educational videos and images to advance and educate the public and clinicians regarding new and improved neuroscience techniques. 6805 5000 0 Support of the education and collaboration of neuroscientists and clinicians regarding techniques for the optimization of brian health. 199949 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 1 4 0 1 0 0 0 0 0 0 0 0 0 0 0 X 4 3 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 0 0 0 0 0 CA X Daniel F Kelly MD 3105827450 2200 Santa Monica Blvd Santa monica CA 90404 X Daniel F Kelly MD President & CEO 10.00 2.00 X X 0 0 0 Chester F Griffiths MD Chairperson 8.00 2.00 X X 0 0 0 Howard R Krauss MD CFO 3.00 1.00 X X 0 0 0 Santosh Kesari MD Secretary 4.00 1.00 X X 0 0 0 0 0 0 0 0 0 0 0 749455 749455 55 55 749510 0 0 55 5000 5000 41001 41001 49276 24638 24638 151 151 102168 76626 25542 1805 1805 41389 41389 Community outreach & pa 75129 75129 112 112 316031 199949 65902 50180 0 0 0 16051 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 455279 0 0 0 471330 0 37851 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37851 X 0 0 0 0 0 433479 0 433479 0 471330 433479 0 X 0 0 0 X 0 749455 749455 0 0 0 0 749455 749455 749455 0 55 55 0 0 749510 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED Daniel F Kelly MD President and Director 496668 The organization purchased intellectual property from the interested person, the consideration for which was valued at the cost for the development of such intellectual property. 0 Daniel F Kelly MD Neurosurgical Inc The president, Daniel F. Kelly, M.D. is the sole owner of the corporation. 127224 Daniel F. Kelly, M.D. Neurosurgical Inc., a professional medical corporation wholly owned by the officer, provided community outreach and public education services to the organization. 0 Form 990, Part VI, Section A, line 2 The officers and directors of the organization are also: i) members and managers in Pacific Neuroscience Institute, LLC; and ii) shareholders, officers and directors in a professional medical corporation (Pacific Neuroscience Institute Medical Group, Inc.). Form 990, Part VI, Section A, line 6 The organization had one member (Pacific Neuroscience Institute, LLC) - the Founding Member. Form 990, Part VI, Section A, line 7a The members elect the governing body of the organization. Form 990, Part VI, Section A, line 7b The members have the authority to approve the governing body's decision to fill a vacancy on the governing body if such vacancy was created by removal of a director, and to approve the amendment of the by-laws. Form 990, Part VI, Section B, line 11b An electronic copy of the Form 990 and its supporting schedules were distributed to the organization's governing body for review prior to filing. Form 990, Part VI, Section B, line 12c The organization's governing body periodically reviews activities in which it and members of its governing body are participating to ensure that any and all arrangements (and especially those which may appear to pose a conflict of interest) are properly documented and reflect reasonable and supportable economic components so as to not result in inurement, impermissible private benefits or excess benefit transactions. Form 990, Part VI, Section C, line 19 The governing documents, conflict of interest policy and financial statements are made available to the public upon request. Pacific Neuroscience Institute LLC 11645 Wilshire blvd 6th Fl Los Angeles CA 90064 472490586 management/investment CA N/A N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0