FORM 1023-EZ for MENTORING FOR CHANGE

Field Data
EIN 36-4884813
Case Number EO-2018004-000065
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MENTORING FOR CHANGE
Organization’s Mailing Address 5709 SAWYER RIIDGE
City PUEBLO
State CO
ZIP 81008
Accounting period End 12
Primary contact name ROEDERICK DION
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RODERICK DION
CHARMAN
5709 SAWYER RIDGE
PUEBLO CO 81008

Officer/Director/Trustee Two

VALERIE ROBERTSON
SECRETARY
5709 SAWYER RIDGE
PUEBLO CO 81008

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/29/17
Organization Incorporation State CO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P01 - Alliance/Advocacy Organizations
Organization’s purpose Charitable: No
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 Yes
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 RODERICK DION
Signature Title CHARMAN
Signature Date 1/2/18

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