FORM 1023-EZ for BEHAVIOR CHANGE CONSULTING INSTITUTE

Field Data
EIN 84-1778952
Case Number EO-2019158-000257
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BEHAVIOR CHANGE CONSULTING INSTITUTE
Organization’s Mailing Address 2113 VIRGINIA ST
City LAWRENCE
State KS
ZIP 66046
Accounting period End 12
Primary contact name MEGAN OBRIEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MEGAN OBRIEN
EXECUTIVE DIRECTOR
2113 VIRGINIA ST
LAWRENCE KS 66046

Officer/Director/Trustee Two

MAURICE BULLS
VICE PRESIDENT
455 S MARSHALL
PONTIAC MI 48342

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/15/19
Organization Incorporation State KS
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E02 - Management & Technical Assistance
Organization’s purpose Charitable: No
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 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 MEGAN OBRIEN
Signature Title EXECUTIVE DIRECTOR
Signature Date 6/5/19

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