FORM 1023-EZ for SPECIAL BLOOMS INC

Field Data
EIN 86-3817586
Case Number EO-2021174-000261
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SPECIAL BLOOMS INC
Organization’s Mailing Address 5915 W 1400 N
City ELWOOD
State IN
ZIP 46036
Accounting period End 12
Primary contact name HELEN GREGORY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KELLY HIATT
PRESIDENT
5915 W 1400 N
ELWOOD IN 46036

Officer/Director/Trustee Two

RUSSELL HIATT JR
VICE PRESIDENT
5915 W 1400 N
ELWOOD IN 46036

Officer/Director/Trustee Three

KARLA JOHNSON
TREASURER
PO BOX 492
ARCADIA IN 46030

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/29/2021
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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 KELLY HIATT
Signature Title PRESIDENT
Signature Date 6/21/2021

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