FORM 1023-EZ for CHOSEN FOR CHANGE COMMUNITY OUTREACH MINISTRIES INC

Field Data
EIN 81-1728026
Case Number EO-2020128-000202
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CHOSEN FOR CHANGE COMMUNITY OUTREACH MINISTRIES INC
Organization’s Mailing Address 5034 LAFAYETTE RD
City INDIANAPOLIS
State IN
ZIP 46254
Accounting period End 4
Primary contact name MARK CORNNER JR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MARK CORNNER JR
PASTOR
5034 LAFAYETTE ROAD
INDIANAPOLIS IN 46254

Officer/Director/Trustee Two

SHALONDA WILLIAMS
TRUSTEE
3671 SOMMERSWORTH LN
INDIANAPOLIS IN 46228

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/18/2016
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A19 - Nonmonetary Support N.E.C.*
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 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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name MARK CORNNER JR
Signature Title PASTOR
Signature Date 5/5/2020
EIN 81-1728026
Case Number EO-2016070-000311
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CHOSEN FOR CHANGE COMMUNITY OUTREACH MINISTRY
Organization’s Mailing Address 5034 LAFEYETTE RD
City INDIANAPOLIS
State IN
ZIP 46254
Accounting period End 3
Primary contact name MARK CORNNER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

SHALONDA WILLIAMS
DIRECTOR
5034 LAYFEYETTE RD
INDIANAPOLIS IN 46254

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/5/2012
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X20 - Christian
Organization’s purpose Charitable: No
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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