FORM 1023-EZ for CHANGE YOUR SHOES FOUNDATION INC

Field Data
EIN 47-3254990
Case Number EO-2015098-000260
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CHANGE YOUR SHOES FOUNDATION INC
Organization’s Mailing Address 15722 SUNNYLAND LN
City WELLINGTON
State FL
ZIP 33414-7136
Accounting period End 12
Primary contact name KATHERINE ANDERSEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

KATHERINE ANDERSEN
DIRECTOR AND PRESIDENT/CEO
90 ALTON ROAD SUITE 3102
MIAMI BEACH FL 33139-6889

Officer/Director/Trustee Two

AWA LODMELL
DIRECTOR AND SECRETARY
2005 GREENBRIAR BLVD
WELLINGTON FL 33414-8341

Officer/Director/Trustee Three

DOUGLASS LODMELL
DIRECTOR
2005 GREENBRIAR BLVD
WELLINGTON FL 33414-8341

Officer/Director/Trustee Four

LAURA HANSON VIRGINIA
DIRECTOR AND TREASURER
15535 SUNWARD ST
WELLINGTON FL 33414-8335

Organization’s website WWW.CHANGEYOURSHOESFOUNDATION.ORG
Organization’s email INFO@CHANGEYOURSHOESFOUNDATION.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/18/2015
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W12 - Fund Raising and/or Fund Distribution
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 Yes
Conducting Activities Outside of United States Yes
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
Signature Title
Signature Date

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