FORM 1023-EZ for YOUTH FOR A POSITIVE CHANGE

Field Data
EIN 36-4344034
Case Number EO-2015084-000297
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name YOUTH FOR A POSITIVE CHANGE
Organization’s Mailing Address 4920 179TH STREET
City COUNTRY CLUB HILLS
State IL
ZIP 60478
Accounting period End 12
Primary contact name DIANE SIMPSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DIANE SIMPSON
PRESIDENT/DIRECTOR
4920 179TH STREET
COUNTRY CLUB HILLS IL 60478

Officer/Director/Trustee Two

LINDA TOLLIVER
TREASURER/DIRECTOR
4920 179TH STREET
COUNTRY CLUB HILLS IL 60478

Officer/Director/Trustee Three

ADRIENNE WATSON
SECRETARY/DIRECTOR
4920 179TH STREET
COUNTRY CLUB HILLS IL 60478

Officer/Director/Trustee Four

ELNOR SAVERSON
BOARD MEMBER/DIRECTOR
4920 179TH STREET
COUNTRY CLUB HILLS IL 60478

Officer/Director/Trustee Five

ANTHONY JORDAN
BOARD MEMBER/DIRECTOR
4920 179TH STREET
COUNTRY CLUB HILLS IL 60478

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/1/1986
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
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 Yes
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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