FORM 1023-EZ for LIFE CHANGING MENTORING INC

Field Data
EIN 83-3796976
Case Number EO-2020265-000772
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LIFE CHANGING MENTORING INC
Organization’s Mailing Address 827 SOUTHVIEW CIRCLE
City FAYETTEVILLE
State NC
ZIP 28311
Accounting period End 12
Primary contact name BRYAN TILLMAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BRYAN TILLMAN
PRESIDENT
827 SOUTHVIEW CIRCLE
FAYETEVILLE NC 28311

Officer/Director/Trustee Two

JOHN GODBOLT
SECRETARY
1608 ELK RUN DRIVE
FAYETTEVILLE NC 28312

Officer/Director/Trustee Three

CURTIS BROWN
TREASURER
3531 GILLESPIE ST
FAYETTEVILLE NC 28306

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/30/2020
Organization Incorporation State NC
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: Yes
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 Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name BRYAN TILLMAN
Signature Title PRESIDENT
Signature Date 9/19/2020

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