FORM 1023-EZ for BLOSSOM AND FLOURISH

Field Data
EIN 35-2568475
Case Number EO-2016347-000168
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BLOSSOM AND FLOURISH
Organization’s Mailing Address 6 CLARION AVENUE
City PITTSBURGH
State PA
ZIP 15202-1227
Accounting period End 12
Primary contact name VALERIE FAUST
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

VALERIE FAUST
EXECUTIVE DIRECTOR
6 CLARION AVE
PITTSBURGH PA 15202-1227

Officer/Director/Trustee Two

KATHLEEN CODER
DIRECTOR
25 N BRYANT AVE
PITTSBURGH PA 15202-1227

Officer/Director/Trustee Three

JOHN STANKO
DIRECTOR
12 MORNINGTIDE CT
MONROEVILLE PA 15146-4772

Officer/Director/Trustee Four

KELLY SASSAMAN
DIRECTOR
208 CRICKETWOOD CT
CRANBERRY PA 16066-4722

Officer/Director/Trustee Five

BRANDEN BALLARD
DIRECTOR
1914 PERRYSVILLE AVE APT 3
PITTSBURGH PA 15214-3826

Organization’s website N/A
Organization’s email VFAUST@LIVE.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/15/2016
Organization Incorporation State PA
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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