FORM 1023-EZ for BLUE ROSE MISSION INC

Field Data
EIN 84-4093479
Case Number EO-2020156-000146
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BLUE ROSE MISSION INC
Organization’s Mailing Address PO BOX 3834
City MANSFIELD
State OH
ZIP 44907-3834
Accounting period End 12
Primary contact name ABBY MCCREADY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ABBY MCCREADY
EXECUTIVE DIRECTOR
955 MAUMEE AVE
MANSFIELD OH 44906-2908

Officer/Director/Trustee Two

DAVID CARDWELL
CHAIRMAN OF THE BOARD
1120 WHIPPOORWILL LN
MANSFIELD OH 44906-3490

Officer/Director/Trustee Three

MATTHEW MERRIMAN
VICE CHAIRMAN OF THE BOARD
16533 N RED ROCK DR
STRONGSVILLE OH 44136-7331

Officer/Director/Trustee Four

STANLEY WERTZ
SECRETARY
899 PUGH RD
MANSFIELD OH 44903-8757

Officer/Director/Trustee Five

DANIELLE KELBLEY
BOOKKEEPER
33 W GAYLORD AVE
SHELBY OH 44875-1605

Organization’s website WWW.BLUEROSEMISSION.ORG
Organization’s email WORKMISSION@BLUEROSEMISSION.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/9/2020
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code L81 - Home Improvement and Repairs
Organization’s purpose Charitable: Yes
Religious: Yes
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 Yes
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name ABBY MCCREADY
Signature Title EXECUTIVE DIRECTOR
Signature Date 6/2/2020

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