FORM 1023-EZ for CHANGING LIVES THROUGH THE ARTS

Field Data
EIN 47-3885507
Case Number EO-2016057-000093
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CHANGING LIVES THROUGH THE ARTS
Organization’s Mailing Address PO BOX 246624
City PEMBROKE PINES
State FL
ZIP 33024
Accounting period End 2
Primary contact name ANDRIEVE DACOSTA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

TANIELLE DACOSTA
TREASURER
6831 SW 16 ST
PEMBROKE PINES FL 33023

Officer/Director/Trustee Two

ANDRIEVE DACOSTA
DIRECTOR
6831 SW 16 ST
PEMBROKE PINES FL 33023

Organization’s website CHANGINGLIVESTHROUGHTHEARTS.ORG
Organization’s email CLTT.ARTS@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/14/2015
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A20 - Arts, Cultural 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 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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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