FORM 1023-EZ for BLUE ZONE RESEARCH INC

Field Data
EIN 87-1904018
Case Number EO-2021218-000145
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BLUE ZONE RESEARCH INC
Organization’s Mailing Address 151 OLEY LINE RD
City DOUGLASSVILLE
State PA
ZIP 19518
Accounting period End 12
Primary contact name ROXANNE STONE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LISA GIFFORD
DIRECTOR
151 OLEY LINE RD
DOUGLASSVILLE PA 19518

Officer/Director/Trustee Two

JACQUELINE HILL
DIRECTOR
151 OLEY LINE RD
DOUGLASSVILLE PA 19518

Officer/Director/Trustee Three

ROXANNE STONE
DIRECTOR
151 OLEY LINE RD
DOUGLASSVILLE PA 19518

Organization’s website
Organization’s email ROXANNE@TRINITYCLEANFOODS.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/8/2021
Organization Incorporation State PA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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 ROXANNE STONE
Signature Title DIRECTOR
Signature Date 8/4/2021

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