FORM 1023-EZ for BLUE ROSE FAMILY FOUNDATION

Field Data
EIN 47-2530129
Case Number EO-2018057-000546
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BLUE ROSE FAMILY FOUNDATION
Organization’s Mailing Address 10286 STAPLES MILL ROAD NUM 240
City GLEN ALLEN
State VA
ZIP 23060-3743
Accounting period End 12
Primary contact name LINDA SMITH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LINDA SMITH
TRUSTEE
10286 STAPLES MILL ROAD NUM 240
GLEN ALLEN VA 23060-3743

Officer/Director/Trustee Two

ROBERT SMITH
TRUSTEE
10286 STAPLES MILL ROAD NUM 240
GLEN ALLEN VA 23060-3743

Organization’s website
Organization’s email
Organization Incorporated
Organization trust Yes
Necessary Organizing Documents Yes
Organization Incorporation Date 12/12/14
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T20 - Private Grantmaking Foundations
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
Scientific: Yes
Literary: Yes
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement Yes
Correctness Declaration Yes
Signature Name LINDA SMITH
Signature Title TRUSTEE
Signature Date 2/23/18
EIN 47-2530129
Case Number EO-2014356-000459
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BLUE ROSE FAMILY FOUNDATION
Organization’s Mailing Address 10286 STAPLES MILL ROAD NUM 240
City GLEN ALLEN
State VA
ZIP 23060
Accounting period End 12
Primary contact name LINDA SMITH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

LINDA SMITH
TRUSTEE
10286 STAPLES MILL ROAD NUM 240
GLEN ALLEN VA 23060

Officer/Director/Trustee Two

ROBERT SMITH
TRUSTEE
10286 STAPLES MILL ROAD NUM 240
GLEN ALLEN VA 23060

Organization’s website
Organization’s email
Organization Incorporated
Organization trust Yes
Necessary Organizing Documents Yes
Organization Incorporation Date 12/12/2014
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T20 - Private Grantmaking Foundations
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
Scientific: Yes
Literary: Yes
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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