FORM 1023-EZ for CHANGE IS OURS INCORPORATION

Field Data
EIN 81-3930508
Case Number EO-2016309-000134
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CHANGE IS OURS INCORPORATION
Organization’s Mailing Address 15436 NW 12TH COURT
City PEMBROKE PINES
State FL
ZIP 33028
Accounting period End 12
Primary contact name SULANY PEREZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SULANY PEREZ
DIRECTOR
14522 SW 75TH STREET
MIAMI FL 33183

Officer/Director/Trustee Two

SILVIA MEDINA
DIRECTOR
1260 NW 161ST AVENUE
PEMBROKE PINES FL 33028

Officer/Director/Trustee Three

MELODY DUARTE
DIRECTOR
16300 NW 12TH STREET
PEMBROKE PINES FL 33028

Officer/Director/Trustee Four

NATALIE LANGE
DIRECTOR
15436 NW 12TH COURT
PEMBROKE PINES FL 33028

Officer/Director/Trustee Five

GISSELLE PUENTES
DIRECTOR
16510 NW 5TH COURT
PEMBROKE PINES FL 33028

Organization’s website
Organization’s email CHANGEISOURS.INFO@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/20/2015
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T70 - Fund Raising Organizations That Cross Categories
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 No
Conducting Activities Outside of United States Yes
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance Yes
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 Yes
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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