FORM 1023-EZ for HEALTH CONTRIBUTION INC

Field Data
EIN 81-2729580
Case Number EO-2016201-000324
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HEALTH CONTRIBUTION INC
Organization’s Mailing Address 4561 MEDITERRANEAN CIR
City PALM BEACH GARDENS
State FL
ZIP 33418
Accounting period End 12
Primary contact name SCOTT TUCKER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SCOTT TUCKER
PRESIDENT
4561 MEDITERRANEAN CIR
PALM BEACH GARDENS FL 33418

Officer/Director/Trustee Two

ANA TUCKER
DIRECTOR
4561 MEDITERRANEAN CIR
PALM BEACH GARDENS FL 33418

Officer/Director/Trustee Three

MARCEL ORTIZ
DIRECTOR
5452 NW 172 TERRACE
CAROL CITY FL 33055

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/19/2016
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E70 - Public Health Program (Includes General Health and Wellness Promotion Services)
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 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
Signature Title
Signature Date

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