FORM 1023-EZ for FIRST CAPITAL CORNERSTONE OF CHANGE

Field Data
EIN 86-1377296
Case Number EO-2021078-000778
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name FIRST CAPITAL CORNERSTONE OF CHANGE
Organization’s Mailing Address 3220 CATTAIL ROAD
City CHILLICOTHE
State OH
ZIP 45601
Accounting period End 1
Primary contact name STACEY SAUNDERS-ADAMS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CHRISTINA ARREDONDO
DIRECTOR
582 JOHNSON RD
CHILLICOTHE OH 45601

Officer/Director/Trustee Two

TRACY KEMPER
TRUSTEE
189 VINE ST
CHILLICOTHE OH 45601

Officer/Director/Trustee Three

STACEY SAUNDERS-ADAMS
TRUSTEE
3220 CATTAIL RD
CHILLICOTHE OH 45601

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/14/2021
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F20 - Alcohol, Drug and Substance Abuse, Dependency Prevention and Treatment
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 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 STACEY SAUNDERS-ADAMS
Signature Title TRUSTEE
Signature Date 1/22/2021

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