FORM 1023-EZ for BLOSSOM BAKERY

Field Data
EIN 85-3489814
Case Number EO-2020300-000338
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BLOSSOM BAKERY
Organization’s Mailing Address 5614 CONNECTICUT AVE NW NUMBER 140
City WASHINGTON
State DC
ZIP 20015-2604
Accounting period End 12
Primary contact name MARISSA JACOBSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MARISSA JACOBSON
PRESIDENT
5614 CONNECTICUT AVE NW NUMBER 140
WASHINGTON DC 20015-2604

Officer/Director/Trustee Two

WILLIAM JACOBSON
TREASURER
5614 CONNECTICUT AVE NW NUMBER 140
WASHINGTON DC 20015-2604

Officer/Director/Trustee Three

MARIA PETAROS
SECRETARY
5614 CONNECTICUT AVE NW NUMBER 140
WASHINGTON DC 20015-2604

Officer/Director/Trustee Four

JENNIFER LANOFF
OFFICER
5614 CONNECTICUT AVE NW NUMBER 140
WASHINGTON DC 20015-2604

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/8/2020
Organization Incorporation State DC
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name MARISSA JACOBSON
Signature Title PRESIDENT
Signature Date 10/22/2020

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