FORM 1023-EZ for BLOSSOM PROSPERITY HOUSE

Field Data
EIN 85-1383680
Case Number EO-2020181-000212
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BLOSSOM PROSPERITY HOUSE
Organization’s Mailing Address 20505 WATSON RD
City MAPLE HTS
State OH
ZIP 44137
Accounting period End 12
Primary contact name DEVIN RICHARDSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DEVIN RICHARDSON
CEO
20505 WATSON RD
MAPLE HTS OH 44137

Officer/Director/Trustee Two

ARIEL MARBURY
TREASURER
14714 CORRIDON AVE
MAPLE HTS OH 44137

Officer/Director/Trustee Three

SONITA YOUNG
PRESIDENT
951 ARCHER RD
BEDFORD OH 44146

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/8/2020
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 DEVIN RICHARDSON
Signature Title CEO
Signature Date 6/25/2020

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