FORM 1023-EZ for BLIND LIVES MATTER FOUNDATION

Field Data
EIN 47-5646801
Case Number EO-2017052-000389
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BLIND LIVES MATTER FOUNDATION
Organization’s Mailing Address 480 PENHOW CIRCLE
City SACRAMENTO
State CA
ZIP 95834-2585
Accounting period End 11
Primary contact name FLOYD ARMBRESTER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

FLOYD ARMBRESTER
PRESIDENT
480 PENHOW CIRCLE
SACRAMENTO CA 95834-2585

Officer/Director/Trustee Two

SHAVEL FARRIS
SECRETARY
480 PENHOW CIRCLE
SACRAMENTO CA 95834-2585

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/2/2015
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G41 - Eye Diseases, Blindness and Vision Impairments
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 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
Signature Title
Signature Date

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