FORM 1023-EZ for IMPACT TO CHANGE INCORPORATION
| Field | Data |
|---|---|
| EIN | 85-1490936 |
| Case Number | EO-2020174-000665 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | IMPACT TO CHANGE INCORPORATION |
| Organization’s Mailing Address | 98 SONNYBROOK LANE |
| City | KEYSER |
| State | WV |
| ZIP | 26726 |
| Accounting period End | 12 |
| Primary contact name | LINDA H WALLACE |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
DEBRA PENDARVIS
PRESIDENT/FOUNDER
98 SONNYBROOK LANE
KEYSER WV 26726
Officer/Director/Trustee Two
TERESA SHARP
VICE PRESIDENT
112 SHELBY COURT
WINCHESTER VA 22602
Officer/Director/Trustee Three
ALYCIA CARLILE
SECRETARY
22703 MINNETONKA AVE APT 203
WESTERNPORT MD 21562
Officer/Director/Trustee Four
WENDY SOKOL
TREASURER
112 SHELBY COURT
WINCHESTER WV 26726
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 6/18/2020 |
| Organization Incorporation State | WV |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | P20 - Human Service Organizations - Multipurpose |
| Organization’s purpose | Charitable: Yes Religious: Yes 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 | DEBRA PENDARVIS |
| Signature Title | PRESIDENT/FOUNDER |
| Signature Date | 6/18/2020 |
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