FORM 1023-EZ for BLOCKER FAMILY FOUNDATION

Field Data
EIN 85-3188543
Case Number EO-2021175-000194
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BLOCKER FAMILY FOUNDATION
Organization’s Mailing Address 1223 E LANVALE ST
City BALTIMORE
State MD
ZIP 21202
Accounting period End 12
Primary contact name ODELL BLOCKER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ODELL BLOCKER
TRUSTEE & PRESIDENT
356 MASTERS CLUB
HAMPTON GA 30228

Officer/Director/Trustee Two

BRANDI BLOCKER
TRUSTEE & TREASURER
356 MASTERS CLUB
HAMPTON GA 30228

Officer/Director/Trustee Three

QUINTIN LATHAN
SECRETARY
3110 TIOGA PKWY
BALTIMORE MD 21215

Organization’s website
Organization’s email
Organization Incorporated
Organization trust Yes
Necessary Organizing Documents Yes
Organization Incorporation Date 9/25/2020
Organization Incorporation State MD
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E20 - Hospitals and Related Primary Medical Care Facilities
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name ODELL BLOCKER
Signature Title TRUSTEE & PRESIDENT
Signature Date 6/22/2021

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