FORM 1023-EZ for CHANGING THE MINDSET INC

Field Data
EIN 84-2664901
Case Number EO-2019318-000183
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CHANGING THE MINDSET INC
Organization’s Mailing Address 9290 FRONT NINE DR 102
City LAKELAND
State TN
ZIP 38002
Accounting period End 6
Primary contact name SHMEKA GIBSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHMEKA GIBSON
PRESIDENT
9290 FRONT NINE DR 102
LAKELAND TN 38002

Officer/Director/Trustee Two

LAQUITA COLE
SITE DIRECTOR
9290 FRONT NINE DR
LAKELAND TN 38002

Officer/Director/Trustee Three

EBONY TRIPLETT
COMPLIANCE EDUCATOR
9290 FRONT NINE DR 102
LAKELAND TN 38002

Officer/Director/Trustee Four

CASSANDRA RUFFIN
PARENT EDUCATOR
9290 FRONT NINE DR 102
LAKELAND TN 38002

Organization’s website WWW.CHANGINGTHEMINDSET.ORG
Organization’s email INFO@CHANGINGTHEMINDSET.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/12/19
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code J11 - Single Organization Support
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 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 SHMEKA GIBSON
Signature Title PRESIDENT
Signature Date 11/12/19

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