FORM 1023-EZ for AMBASSADORS OF CHANGE INCORPORATED

Field Data
EIN 81-4748731
Case Number EO-2017003-000248
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name AMBASSADORS OF CHANGE INCORPORATED
Organization’s Mailing Address 3146 PITTARD HILL POINT
City DULUTH
State GA
ZIP 30096
Accounting period End 12
Primary contact name PATRICE HARRISON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PATRICE HARRISON
PRESIDENT/CEO
3146 PITTARD HILL PT
DULUTH GA 30096

Officer/Director/Trustee Two

LORIE STEPHENS
TREASURER
4000 SE 86TH PLACE
OKLAHOMA CITY OK 73135

Officer/Director/Trustee Three

SEYMORE HARRISON
CHAIR PERSON
3146 PITTARD HILL PT
DULUTH GA 30096

Organization’s website
Organization’s email PATRICE@PATRICEEMPOWERS.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/28/2016
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W70 - Leadership Development
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 Yes
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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