FORM 1023-EZ for CHECKOUT 4 CHANGE

Field Data
EIN 47-5559520
Case Number EO-2019357-000373
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CHECKOUT 4 CHANGE
Organization’s Mailing Address 44A CUMBERLAND STREET
City BRUNSWICK
State ME
ZIP 04011-1928
Accounting period End 3
Primary contact name MICHAEL SAMMON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MICHAEL SAMMON
FOUNDER
44A CUMBERLAND STREET
BRUNSWICK ME 04011-1928

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/25/2015
Organization Incorporation State DE
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code K31 - Food Banks, Food Pantries
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name MICHAEL SAMMON
Signature Title FOUNDER
Signature Date 12/19/2019
EIN 47-5559520
Case Number EO-2015327-000340
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CHECKOUT 4 CHANGE
Organization’s Mailing Address 207 WEST 98 ST APT 8B
City NEW YORK
State NY
ZIP 10025-5672
Accounting period End 3
Primary contact name MICHAEL SAMMON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MICHAEL SAMMON
EXECUTIVE DIRECTOR
207 W 98 APT 8B
NEW YORK NY 10025-5672

Organization’s website CHECKOUT-FOR-CHANGE.ORG
Organization’s email MSAMMON@CHECKOUT-FOR-CHANGE.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/25/2015
Organization Incorporation State DE
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code K12 - Fund Raising and/or Fund Distribution
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 No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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