FORM 1023-EZ for REPURPOSED BLOOMS

Field Data
EIN 83-1162875
Case Number EO-2018197-000404
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name REPURPOSED BLOOMS
Organization’s Mailing Address 2879 ACTON ROAD APT H
City VESTAVIA
State AL
ZIP 35243
Accounting period End 12
Primary contact name HALEY SLY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

HALEY SLY
CHIEF EXECUTIVE OFFICER
2879 ACTON ROAD APT H
VESTAVIA AL 35243-2507

Officer/Director/Trustee Two

GLORIA BALLARD
TREASURER/VICE CHAIR
2885 ACTON ROAD APT F
VESTAVIA AL 35243-2507

Officer/Director/Trustee Three

PATTI MOLLICA
SECRETARY
1736 ROCKHAMPTON CIRCLE
HOOVER AL 35226-2614

Officer/Director/Trustee Four

SHELBY CHESHIER
CHAIRPERSON
95 SMITH STREET
RIVERSIDE AL 35135-1426

Officer/Director/Trustee Five

THERESA LADNER
BOARD MEMBER
18488 LANDON ROAD
GULFPORT MS 39503-8615

Organization’s website WWW.REPURPOSEDBLOOMS.ORG
Organization’s email REPURPOSEDBLOOMS@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/9/18
Organization Incorporation State AL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P58 - Gift Distribution
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 Yes
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 HALEY SLY
Signature Title CHIEF EXECUTIVE OFFICER
Signature Date 7/13/18

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