FORM 1023-EZ for I AM CHANGE OUTREACH

Field Data
EIN 82-0924980
Case Number EO-2018030-000202
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name I AM CHANGE OUTREACH
Organization’s Mailing Address 1084 BRENTNELL AVE
City COLUMBUS
State OH
ZIP 43219
Accounting period End 12
Primary contact name CHARLES M DOBBINS JR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CHARLES DOBBINS
EXECUTIVE DIRECTOR
1084 BRENTNELL AVE
COLUMBUS OH 43219

Officer/Director/Trustee Two

LARRY DAVIS
TRUSTEE
1084 BRENTNELL AVE
COLUMBUS OH 43219

Officer/Director/Trustee Three

LONDALE TOWNS
TRUSTEE
1084 BRENTNELL AVE
COLUMBUS OH 43219

Officer/Director/Trustee Four

JOSEPH LONG
TRUSTEE
1084 BRENTNELL AVE
COLUMBUS OH 43219

Officer/Director/Trustee Five

CARMEN DOBBINS
TRUSTEE
1084 BRENTNELL AVE
COLUMBUS OH 43219

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/27/17
Organization Incorporation State OH
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: 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 Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name CHARLES DOBBINS
Signature Title EXECUTIVE DIRECTOR
Signature Date 1/28/18

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