FORM 1023-EZ for BLOC LIFE INC

Field Data
EIN 83-1291395
Case Number EO-2018241-000211
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BLOC LIFE INC
Organization’s Mailing Address 2535 JEFFERSON ST
City KANSAS CITY
State MO
ZIP 64108
Accounting period End 12
Primary contact name MATT SCANLON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MATT SCANLON
DIRECTOR, PRESIDENT
2535 JEFFERSON ST
KANSAS CITY MO 64108

Officer/Director/Trustee Two

DAVID OCHOA
DIRECTOR
2113 W 49TH TERR
WESTWOOD HILLS KS 66205

Officer/Director/Trustee Three

JACOB BEAUMONT
DIRECTOR, TREASURER
4005 BELL ST
KANSAS CITY MO 64111

Officer/Director/Trustee Four

JILL MUELLER
DIRECTOR
1101 WALNUT UNIT 2004
KANSAS CITY MO 64106

Officer/Director/Trustee Five

MAGGIE SCANLON
SECRETARY
2535 JEFFERSON ST
KANSAS CITY MO 64108

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/27/18
Organization Incorporation State MO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P99 - Human Services - Multipurpose and Other N.E.C.
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 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 MATT SCANLON
Signature Title DIRECTOR, PRESIDENT
Signature Date 8/27/18

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