FORM 1023-EZ for BOLIVIAN HEALTH FOUNDATION LLC

Field Data
EIN 83-2238610
Case Number EO-2018296-000365
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BOLIVIAN HEALTH FOUNDATION LLC
Organization’s Mailing Address 1718 E SPEEDWAY BLVD STE 4081
City TUCSON
State AZ
ZIP 85719
Accounting period End 12
Primary contact name JONATHAN DOELDER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JONATHAN DOELDER
PRESIDENT
1718 E SPEEDWAY BLVD STE 4081
TUCSON AZ 85719

Organization’s website HTTP://HEALTHPROMOTE.US
Organization’s email INFO@HEALTHPROMOTE.US
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/31/18
Organization Incorporation State AZ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code K20 - Agricultural Programs
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 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 JONATHAN DOELDER
Signature Title PRESIDENT
Signature Date 10/21/18

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