FORM 1023-EZ for DESTINED 4 CHANGE MENTORSHIP PROGRAM
| Field | Data |
|---|---|
| EIN | 81-4734965 |
| Case Number | EO-2020083-000443 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | DESTINED 4 CHANGE MENTORSHIP PROGRAM |
| Organization’s Mailing Address | 2870 EASTLAND DRIVE |
| City | EAST POINT |
| State | GA |
| ZIP | 30344 |
| Accounting period End | 12 |
| Primary contact name | ANASTASIOS MANETTAS |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
GARY DUBOSE
DIRECTOR
2870 EASTLAND DRIVE
EAST POINT GA 30344
| Organization’s website | |
|---|---|
| Organization’s email | DESTINED4CHANGEATL@GMAIL.COM |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 1/13/2016 |
| Organization Incorporation State | GA |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | O30 - Adult, Child Matching Programs |
| 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 | No |
| One Third Support Gifts | No |
| Benefit of College | No |
| Private Foundation 508(e) | Yes |
| Seeking Retroactive Reinstatement | No |
| Seeking Section 7 Reinstatement | No |
| Correctness Declaration | Yes |
| Signature Name | GARY DUBOSE |
| Signature Title | DIRECTOR |
| Signature Date | 3/20/2020 |
| EIN | 81-4734965 |
| Case Number | EO-2017268-000495 |
| Form 1023-EZ version | 62014 |
| Eligibility Worksheet | 1 |
| Organization Name | DESTINED 4 CHANGE MENTORSHIP PROGRAM INC |
| Organization’s Mailing Address | 2870 HEADLAND DRIVE |
| City | EAST POINT |
| State | GA |
| ZIP | 30344 |
| Accounting period End | 12 |
| Primary contact name | ANASTASIOS MANETTAS |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
CHRISTOPHER TAYLOR
DIRECTOR
2870 HEADLAND DRIVE
EAST POINT GA 30344
Officer/Director/Trustee Two
GARY DUBOSE
SECRETARY
2870 HEADLAND DRIVE
EAST POINT GA 30344
Officer/Director/Trustee Three
TIESHA TAYLOR
TREASURER
2870 HEADLAND DRIVE
EAST POINT GA 30344
Officer/Director/Trustee Four
ANASTASIOS MANETTAS
GENERAL COUNSEL
2870 HEADLAND DRIVE
EAST POINT GA 30344
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 4/18/2016 |
| Organization Incorporation State | GA |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | O50 - Youth Development Programs, Other |
| 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 | No |
| One Third Support Gifts | No |
| Benefit of College | No |
| Private Foundation 508(e) | Yes |
| Seeking Retroactive Reinstatement | No |
| Seeking Section 7 Reinstatement | No |
| Correctness Declaration | Yes |
| Signature Name | |
| Signature Title | |
| Signature Date |
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