FORM 1023-EZ for CHANGE ME FOUNDATION INC

Field Data
EIN 85-0697215
Case Number EO-2020233-000332
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CHANGE ME FOUNDATION INC
Organization’s Mailing Address 735 NW 10TH AVE APT 101
City FORT LAUDERDALE
State FL
ZIP 33311
Accounting period End 12
Primary contact name JJARVIS BRUNSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JARVIS BRUNSON
EXECUTIVE DIRECTOR
735 NW 10TH AVE 101
FORT LAUDERDALE FL 33311

Officer/Director/Trustee Two

JARITA BRUNSON
SECRETARY
735 NW 10TH AVE 101
FORT LAUDERDALE FL 33311

Officer/Director/Trustee Three

DAVID DURESKY
VICE PRESIDENT
2903 SW 2ND PLACE
CAPE CORAL FL 33914

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/1/2020
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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 JARVIS BRUNSON
Signature Title EXECUTIVE DIRECTOR
Signature Date 8/18/2020

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