FORM 1023-EZ for CHANGING MINDS

Field Data
EIN 82-0806312
Case Number EO-2017130-000517
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CHANGING MINDS
Organization’s Mailing Address 371 OLD HOUSE RD
City RIDGELAND
State SC
ZIP 29936
Accounting period End 3
Primary contact name JACQUELINE CANNICK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JACQUELINE CANNICK
EXECUTIVE DIRECTOR
371 OLDHOUSE RD
RIDGELAND SC 29936

Officer/Director/Trustee Two

DANTE JACKSON
DIRECTOR
371 OLDHOUSE RD
RIDGELAND SC 29936

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/14/2017
Organization Incorporation State SC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F80 - Mental Health Association, Multipurpose
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 Yes
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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