FORM 1023-EZ for BLOOMING MEMORIES THRU MUSIC

Field Data
EIN 81-3882225
Case Number EO-2016265-000216
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BLOOMING MEMORIES THRU MUSIC
Organization’s Mailing Address 4949 E RIDGEWOOD DR
City BLOOMINGTON
State IN
ZIP 47401
Accounting period End 12
Primary contact name PENNY ANN FISHER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PENNY FISHER
OFFICER AND TREASURER
4949 E RIDGEWOOD DR
BLOOMINGTON IN 47401

Officer/Director/Trustee Two

BARBARA EDMONDS
DESIGN ORGANIZATION
P O 8182
BLOOMINGTON IN 47407-8182

Officer/Director/Trustee Three

CLEVE WILHOIT
ALZHEIMER'S FAMILY FACILITATOR
926 HIGHLND AVE
BLOOMINGTON IN 47401

Organization’s website
Organization’s email BLOOMINGMEMORIESTHRUMUSIC@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/19/2016
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G83 - Alzheimer's Disease
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 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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