FORM 1023-EZ for BLANKET THERAPEUTICS LLC

Field Data
EIN 47-3018923
Case Number EO-2015335-000182
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BLANKET THERAPEUTICS LLC
Organization’s Mailing Address 564 EILER
City ST LOUIS
State MO
ZIP 63111-1820
Accounting period End 12
Primary contact name SHAUNE SCOTT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

LATASHA BURESS
PRESIDENT
5206 BANCROFT AVENUE
ST LOUIS MO 63109-2314

Officer/Director/Trustee Two

MARCUS JOSEPH
TREASUER
14424 DICKENS AVENUE
SHERMAN OAKS CA 91423-4008

Officer/Director/Trustee Three

ANITA WILDER
SECRETARY
1505 SURF SIDE DRIVE
ST LOUIS MO 63138-2342

Officer/Director/Trustee Four

ANTHONY GRAY
BOARD MEMBER
7710 CARONDELET AVENUE
ST LOUIS MO 63105-3319

Officer/Director/Trustee Five

HENRY GRAHAM
BOARD MEMBER
1358 HUDSON HILLS DRIVE
FERGUSON MO 63135-1435

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/21/2015
Organization Incorporation State MO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
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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