FORM 1023-EZ for BLB FOUNDATION INC

Field Data
EIN 83-4410468
Case Number EO-2019154-000427
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BLB FOUNDATION INC
Organization’s Mailing Address 6123 WOODFORD DRIVE
City LAKEVIEW
State NY
ZIP 14085
Accounting period End 12
Primary contact name JOSEPH TOMLINSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOSEPH TOMLINSON
DIRECTOR
6123 WOODFORD DRIVE
LAKEVIEW NY 14085

Officer/Director/Trustee Two

KELLIE CHIAVETTA
DIRECTOR
9784 S MAIN STREET
ANGOLA NY 14006

Officer/Director/Trustee Three

RONALD BANKS
DIRECTOR
119 HENNING ROAD
ORCHARD PARK NY 14217

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/19/19
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Y12 - Fund Raising and/or Fund Distribution
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 Yes
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 JOSEPH TOMLINSON
Signature Title DIRECTOR
Signature Date 5/31/19

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