FORM 1023-EZ for CHANGIN YOUR LIFE INCORPORATED
| Field | Data |
|---|---|
| EIN | 86-3721529 |
| Case Number | EO-2021147-000341 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | CHANGIN YOUR LIFE INCORPORATED |
| Organization’s Mailing Address | 3900 CROWN RD SW 16709 |
| City | ATLANTA |
| State | GA |
| ZIP | 30304 |
| Accounting period End | 12 |
| Primary contact name | SHACAYNE JACKSON |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
SHACAYNE JACKSON
DIRECTOR
1507 HARVEST GROVE LANE SE
CONYERS GA 30013
Officer/Director/Trustee Two
DEDRIC JACKSON
DIRECTOR
1588 BRANDON GLEN WAY SE
CONYERS GA 30013
Officer/Director/Trustee Three
ANTHONY JACKSON
DIRECTOR
1507 HARVEST GROVE LANE SE
CONYERS GA 30013
Officer/Director/Trustee Four
LITIKI JACKSON
DIRECTOR
1507 HARVEST GROVE LANE SE
CONYERS GA 30013
Officer/Director/Trustee Five
DERIN GRANADOS
DIRECTOR
1507 HARVEST GROVE LANE SE
CONYERS GA 30013
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 4/30/2021 |
| Organization Incorporation State | GA |
| 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 | Yes |
| 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 | Yes |
| 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 | SHACAYNE JACKSON |
| Signature Title | DIRECTOR |
| Signature Date | 5/25/2021 |
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