FORM 1023-EZ for BLINK VERSE INCORPORATED

Field Data
EIN 82-2710395
Case Number EO-2017269-000187
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BLINK VERSE INCORPORATED
Organization’s Mailing Address 725 WEST FRONTIER LANE/SUITE 301
City OLATHE
State KS
ZIP 66061
Accounting period End 12
Primary contact name EMILY MUSHINSKI
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

EMILY MUSHINSKI
DIRECTOR
12616 WEST 110TH TERRACE
OVERLAND PARK KS 66210

Officer/Director/Trustee Two

NATHAN MUSHINSKI
DIRECTOR
12616 WEST 110TH TERRACE
OVERLAND PARK KS 66210

Officer/Director/Trustee Three

KAITLIN SMITH
BOARD MEMBER
12490 QUIVIRA ROAD/ 2420
OVERLAND PARK KS 66213

Officer/Director/Trustee Four

MARY GIESLER
BOARD MEMBER
11413 CODY STREET
OVERLAND PARK KS 66210

Officer/Director/Trustee Five

KRISTOPHER ESTES-BROWN
BOARD MEMBER
11728 QUIVIRA RD
OVERLAND PARK KS 66210

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/1/2017
Organization Incorporation State KS
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A60 - Performing Arts Organizations
Organization’s purpose Charitable: Yes
Religious: Yes
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 Yes
Donation of funds No
Conducting Activities Outside of United States Yes
Financial transactions with officers Yes
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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