FORM 1023-EZ for ALL STAR HEALTH CENTER INC

Field Data
EIN 84-4847547
Case Number EO-2020062-000436
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ALL STAR HEALTH CENTER INC
Organization’s Mailing Address 138 BUNTROCK AVENUE
City THINESVILLE
State WI
ZIP 53092
Accounting period End 12
Primary contact name GREG DEVORKIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

GREG DEVORKIN
DIRECTOR PRESIDENT
138 BUNTROCK AVENUE
THIENSVILLE WA 53092

Officer/Director/Trustee Two

AMY SEIBEL
DIRECTOR TREASURER
138 BUNTROCK AVENUE
THIENSVILLE WI 53092

Officer/Director/Trustee Three

JOE DEVORKIN
DIRECTOR SECRETARY
138 BUNTROCK AVENUE
THIENSVILLE WI 53092

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/22/2020
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P82 - Developmentally Disabled Centers, 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 GREG DEVORKIN
Signature Title DIRECTOR PRESIDENT
Signature Date 2/28/2020

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