FORM 1023-EZ for BLUE BUTTERFLY HOUSE

Field Data
EIN 82-1119037
Case Number EO-2017111-000230
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BLUE BUTTERFLY HOUSE
Organization’s Mailing Address 2050 S 1400 EAST ST UNIT 22
City ST GEORGE
State UT
ZIP 84790
Accounting period End 3
Primary contact name SUZUN ABBOTT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SUZUN ABBOTT
EXECUTIVE DIRECTOR
2050 S 1400 EAST ST UNIT 22
ST GEORGE UT 84790

Officer/Director/Trustee Two

DEBORAH HEISLER
DIRECTOR
2301 MEADOW VIEW CIRCLE
SANTA CLARA UT 84765

Officer/Director/Trustee Three

DAVID HARLESS
TREASURER
368 S MALL DR UNIT I-204
ST GEORGE UT 84790

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/17/2017
Organization Incorporation State UT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P30 - Children's, Youth Services
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
Signature Title
Signature Date

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