FORM 1023-EZ for CHANGE YOUR MINDSET YOUTH FOUNDATION INC

Field Data
EIN 83-2469507
Case Number EO-2018317-000239
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CHANGE YOUR MINDSET YOUTH FOUNDATION INC
Organization’s Mailing Address 4311 WILSHIRE BLVD STE 315
City LOS ANGELES
State CA
ZIP 90010
Accounting period End 12
Primary contact name JACKIE FOLK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

GARRAIN JONES
CEO
7095 HOLLYWOOD BLVD STE 722
LOS ANGELES CA 90028

Officer/Director/Trustee Two

SONIA CRUZ DAGAR
SECRETARY
7095 HOLLYWOOD BLVD STE 722
LOS ANGELES CA 90028

Officer/Director/Trustee Three

JACKIE FOLK
CFO
7095 HOLLYWOOD BLVD STE 722
LOS ANGELES CA 90028

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/28/16
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
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 JACKIE FOLK
Signature Title CFO
Signature Date 11/8/18

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