FORM 1023-EZ for CHANGE HER STORY INC

Field Data
EIN 82-4649357
Case Number EO-2021258-000254
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CHANGE HER STORY INC
Organization’s Mailing Address 1703 N MCMULLEN BOOTH RD 201
City SAFETY HARBOR
State FL
ZIP 34695
Accounting period End 12
Primary contact name KRISTIN KEEGAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

NAKIA KELLEY
PRESIDENT
323 LOS PRADOS DR
SAFETY HARBOR FL 34695

Officer/Director/Trustee Two

KRISTIN KEEGAN
TREASURER
5237 DEL PRADO BLVD S
CAPE CORAL FL 33904

Officer/Director/Trustee Three

KIMBERLY KINDLE
SECRETARY
1995 ALLERTON WAY
SPRING HILL TN 37174

Organization’s website WWW.CHANGEHERSTORY.ORG
Organization’s email INFO@CHANGEHERSTORY.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/23/2018
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code J20 - Employment Procurement Assistance, Job Training
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 No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name KRISTIN KEEGAN
Signature Title TREASURER
Signature Date 9/13/2021
EIN 82-4649357
Case Number EO-2020121-000298
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CHANGE HER STORY INC
Organization’s Mailing Address 1703 N MCMULLEN BOOTH ROAD 201
City SAFETY HARBOR
State FL
ZIP 34695
Accounting period End 12
Primary contact name NAKIA KELLEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

NAKIA KELLEY
PRESIDENT
1550 S BELCHER ROAD 225
CLEARWATER FL 33764

Officer/Director/Trustee Two

KRISTEN KEEGAN
TREASURER
5237 S DEL PRADO BLVD
CAPE CORAL FL 33904

Officer/Director/Trustee Three

KIMBERLY KINDLE
SECRETARY
1995 ALLERTON WAY
SPRING HILL TN 37174

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/23/2018
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code J30 - Vocational Rehabilitation
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 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 NAKIA KELLEY
Signature Title PRESIDENT
Signature Date 4/28/2020

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