FORM 1023-EZ for BLURRED REFLECTIONS

Field Data
EIN 84-2788036
Case Number EO-2019234-000328
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BLURRED REFLECTIONS
Organization’s Mailing Address 19 PALMETTO AVE
City AKRON
State OH
ZIP 44301
Accounting period End 12
Primary contact name TRISHA EDDY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TRISHA EDDY
CEO
19 PALMETTO AVE
AKRON OH 44301

Officer/Director/Trustee Two

REBA MCCRAY
BOARD MEMBER
345 N FIRESTONE BLVD
AKRON OH 44301

Officer/Director/Trustee Three

LAUREN BAKER
BOARD MEMBER
894 WHITE PINE DR APT C
AKRON OH 44313

Officer/Director/Trustee Four

EMILY ROBERTS GRIFFIN
BOARD MEMBER
1560 BRYDEN DR
AKRON OH 44313

Officer/Director/Trustee Five

ERICA HOWARD
BOARD MEMBER
715 CASTLE BLVD
AKRON OH 44313

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/20/19
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E50 - Rehabilitative Medical Services
Organization’s purpose Charitable: No
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 TRISHA EDDY
Signature Title CEO
Signature Date 8/20/19

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