FORM 1023-EZ for DIVINE CHANGE INC

Field Data
EIN 85-1403746
Case Number EO-2020174-000371
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name DIVINE CHANGE INC
Organization’s Mailing Address 2128 EASY ST
City WAUKESHA
State WI
ZIP 53188
Accounting period End 12
Primary contact name NICK ELLIOTT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

NICK ELLIOTT
PRESIDENT, DIRECTOR
2128 EASY ST
WAUKESHA WI 53188

Officer/Director/Trustee Two

ALINA ELLIOTT
SECRETARY, DIRECTOR
2128 EASY ST
WAUKESHA WI 53188

Officer/Director/Trustee Three

CHERYL ELLIOTT
TREASURER, DIRECTOR
2128 EASY ST
WAUKESHA WI 53188

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/18/2020
Organization Incorporation State WI
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: Yes
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 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 NICK ELLIOTT
Signature Title PRESIDENT, DIRECTOR
Signature Date 6/20/2020

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