FORM 1023-EZ for BLOOM DURHAM

Field Data
EIN 82-2099744
Case Number EO-2017193-000294
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BLOOM DURHAM
Organization’s Mailing Address 1020 VENETIAN CT
City CARY
State NC
ZIP 27518
Accounting period End 12
Primary contact name NITHYA ADUSUMILLI
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

NITHYA ADUSUMILLI
DIRECTOR
1020 VENETIAN COURT
CARY NC 27518

Officer/Director/Trustee Two

VISHNU PATEL
OFFICER
PO BOX 999
HOLLY SPRINGS NC 27540

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/10/2017
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code C40 - Botanical, Horticultural, and Landscape 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 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
Signature Title
Signature Date

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