FORM 1023-EZ for MINDSET CHRISTIAN COUNSELING INC

Field Data
EIN 47-4112027
Case Number EO-2015155-000290
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MINDSET CHRISTIAN COUNSELING INC
Organization’s Mailing Address 1815 THORNHILL RD SUITE 309T
City AUBURNDALE
State FL
ZIP 33823
Accounting period End 4
Primary contact name DERRICK POWELL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DERRICK POWELL
PRESIDENT
916 LAMP POST LANE
LAKELAND FL 33809

Officer/Director/Trustee Two

JANELL CUNNINGHAM
CHIEF COMPLIANCE COMMUNICATIONS
916 LAMP POST LANE
LAKELAND FL 33809

Officer/Director/Trustee Three

AMANDA COLTRE
CHIEF MARKETING OFFICER
1520 COUNTRY RIDGE DR
LAKELAND FL 33801

Officer/Director/Trustee Four

TIFFANY WOOTEN
CHIEF MASS MEDIA OFFICER
3125 WREN LANE
MULBERRY FL 33860

Organization’s website
Organization’s email MINDSET.COUNSELING15@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/22/2015
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F60 - Counseling, Support Groups
Organization’s purpose Charitable: No
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 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
Signature Title
Signature Date

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