FORM 1023-EZ for BLISSFUL BOOMERS

Field Data
EIN 85-3475278
Case Number EO-2021140-000351
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BLISSFUL BOOMERS
Organization’s Mailing Address 1505 CHRISTINE LANE
City ARCADIA
State CA
ZIP 91007
Accounting period End 12
Primary contact name SHIRLEY LAU
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

IAN LAU
PRESIDENT & TREASURER
1505 CHRISTINE LANE
ARCADIA CA 91007

Officer/Director/Trustee Two

AUDREY LAU
SECRETARY
1505 CHRISTINE LANE
ARCADIA CA 91007

Officer/Director/Trustee Three

SHIRLEY LAU
DIRECTOR
1505 CHRISTINE LANE
ARCADIA CA 91007

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/2/2020
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P75 - Senior Continuing Care Communities
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 Yes
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 Yes
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 SHIRLEY LAU
Signature Title DIRECTOR
Signature Date 5/13/2021

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