FORM 1023-EZ for LEADER TRANSITION INSTITUTE INC

Field Data
EIN 83-1748160
Case Number EO-2019105-000359
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LEADER TRANSITION INSTITUTE INC
Organization’s Mailing Address 15 E CHURCHVILLE RD BOX 192
City BEL AIR
State MD
ZIP 21014-3862
Accounting period End 12
Primary contact name ANN S BROCK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ANN BROCK
PRESIDENT & CHIEF EXECUTIVE OFFICER
15 E CHURCHVILLE RD BOX 192
BEL AIR MD 21014-3862

Officer/Director/Trustee Two

ROBERT DIGIACOMO
VICE PRESIDENT, OPERATIONS
15 E CHURCHVILLE RD BOX 192
BEL AIR MD 21014-3862

Officer/Director/Trustee Three

JOHN MULLINS
VICE PRESIDENT, COMMUNICATIONS
15 E CHURCHVILLE RD BOX 192
BEL AIR MD 21014-3862

Officer/Director/Trustee Four

ERNEST ROBINSON
VICE PRESIDENT, GOVERNMENT RELATION
15 E CHURCHVILLE RD BOX 192
BEL AIR MD 21014-3862

Officer/Director/Trustee Five

ELIZABETH BLOCK
SECRETARY / TREASURER
15 E CHURCHVILLE RD BOX 192
BEL AIR MD 21014-3862

Organization’s website HTTP://CHANGING-FOCUS.ORG
Organization’s email ADMIN@LEADERTRANSITIONINSTITUTE.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/21/18
Organization Incorporation State MD
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W70 - Leadership Development
Organization’s purpose Charitable: Yes
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 ANN BROCK
Signature Title PRESIDENT & CHIEF EXECUTIVE OFFICER
Signature Date 4/11/19

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