FORM 1023-EZ for BLOSSOMS PLACE

Field Data
EIN 82-2528706
Case Number EO-2017233-000362
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BLOSSOMS PLACE
Organization’s Mailing Address 729 NORTH GREENVILLE STREET
City HARRODSBURG
State KY
ZIP 40330
Accounting period End 12
Primary contact name LAURA SULLIVAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LAURA SULLIVAN
PRESIDENT/WILD LIFE REHABILITATE
729 NORTH GREENVILLE STREET
HARRODSBURG KY 40330

Officer/Director/Trustee Two

DAVID SULLIVAN
VICE PRESIDENT
729 NORTH GREENVILLE STREET
HARRODSBURG KY 40330

Officer/Director/Trustee Three

GEMMA ZIEGLER
ADMINISTRATOR
145 ELLIOT LANE
HARRODSBURG KY 40330

Officer/Director/Trustee Four

JUSTIN LILLY
LAND MANAGEMENT
729 NORTH GREENVILLE STREET
HARRODSBURG KY 40330

Officer/Director/Trustee Five

SAMANTHA SULLIVAN
TREASURER
1106 POPLAR LEVEL PLAZA
LOUISVILLE KY 40217

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/1/2014
Organization Incorporation State KY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D30 - Wildlife Preservation, Protection
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: Yes
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 Yes
Gaming Activity No
Disaster relief assistance No
One Third Support Public No
One Third Support Gifts Yes
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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