FORM 1023-EZ for CITY CHANGE

Field Data
EIN 87-1700875
Case Number EO-2021242-000132
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CITY CHANGE
Organization’s Mailing Address 634 COURTLAND DRIVE
City HOWARD
State OH
ZIP 43028
Accounting period End 12
Primary contact name DUANE FLORO
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DUANE FLORO
PRESIDENT
634 COURTLAND DRIVE
HOWARD OH 43028

Officer/Director/Trustee Two

DEANA FLORO
VICE-PRESIDENT
634 COURTLAND DRIVE
HOWARD OH 43028

Officer/Director/Trustee Three

VERNITA LAMBERT
SECRETARY-TRESURER
7580 WITCH HAZEL DRIVE
CANAL WINCHESTER OH 43110

Officer/Director/Trustee Four

REGINALD HAYES
MEMBER
2235 STELZER ROAD
COLUMBUS OH 43219

Officer/Director/Trustee Five

VAL HOTZ
MEMBER
PO BOX 777
WORTHINGTON OH 43085

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/14/2021
Organization Incorporation State OH
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 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 DUANE FLORO
Signature Title PRESIDENT
Signature Date 8/26/2021

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