FORM 1023-EZ for BLOSSOMING YOUTH FACILITIES FOUNDATION

Field Data
EIN 82-3661884
Case Number EO-2019329-000652
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BLOSSOMING YOUTH FACILITIES FOUNDATION
Organization’s Mailing Address 308 MAIN ST EAST
City BLOOMING PRAIRIE
State MN
ZIP 55917
Accounting period End 12
Primary contact name TAMZEN JOHNSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TAMZEN JOHNSON
TREASURER
6944 118TH ST SE
BLOOMING PRAIRIE MN 55917-1264

Officer/Director/Trustee Two

SUSAN ZWIENER
VICE PRESIDENT
308 MAIN ST E
BLOOMING PRAIRIE MN 55917

Officer/Director/Trustee Three

STORMY TROM
VICE PRESIDENT
12088 720TH ST
BLOOMING PRAIRIE MN 55917

Officer/Director/Trustee Four

LON THIELE
PRESIDENT
3421 S COUNTY RD 45
OWATONNA MN 55060

Officer/Director/Trustee Five

DAN PEACH
SECRETARY
127 1ST ST SW
BLOOMING PRAIRIE MN 55917

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/20/17
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S20 - Community, Neighborhood Development, Improvement (General)
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 TAMZEN JOHNSON
Signature Title TREASURER
Signature Date 11/23/19

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