FORM 1023-EZ for COUNSELORS FOR CHANGE INC

Field Data
EIN 82-5114340
Case Number EO-2018150-000561
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name COUNSELORS FOR CHANGE INC
Organization’s Mailing Address 2306 SOUTH BABCOCK STREET
City MELBOURNE
State FL
ZIP 32901-5308
Accounting period End 7
Primary contact name STEPHANIE BYRD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

STEPHANIE BYRD
CHAIR
2306 SOUTH BABCOCK STREET
MELBOURNE FL 32901-5308

Officer/Director/Trustee Two

MALAK HAMMAD
TREASURER
3437 COVE COURT
MELBOURNE FL 32935-4701

Officer/Director/Trustee Three

JOEY JACHEC
SECRETARY
2550 CROOKED ANTLER DRIVE
MELBOURNE FL 32934-2833

Organization’s website WWW.COUNSELORSFORCHANGE.ORG
Organization’s email INFO@COUNSELORSFORCHANGE.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/26/18
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: 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 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 STEPHANIE BYRD
Signature Title CHAIR
Signature Date 5/25/18

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