FORM 1023-EZ for HEART OF BLUE AND GOLD INC

Field Data
EIN 84-3392119
Case Number EO-2019350-000195
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HEART OF BLUE AND GOLD INC
Organization’s Mailing Address 11 EDGEWOOD DR
City MELBOURNE
State FL
ZIP 32902
Accounting period End 6
Primary contact name MIA HOSEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MIA HOSEY
PRESIDENT
456 LAKE VICTORIA CIR
MELBOURNE FL 32940

Officer/Director/Trustee Two

ALYCE PERKINS
VICE PRESIDENT
355 MILANO LANE/ 210
MELBOURNE FL 32940

Officer/Director/Trustee Three

BERNADETTE MERRELL
TREASURER
1354 HERITAGE ACRES BLVD
ROCKLEDGE FL 32955

Officer/Director/Trustee Four

MARCIA SOMERSALL
SECRETARY
976 SANGRIA CIR
ROCKLEDGE FL 32955

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/11/2019
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O01 - Alliance/Advocacy Organizations
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 MIA HOSEY
Signature Title PRESIDENT
Signature Date 12/12/2019

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