FORM 1023-EZ for BLUPROVIDERS INCORPORATION

Field Data
EIN 81-3415400
Case Number EO-2016216-000210
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BLUPROVIDERS INCORPORATION
Organization’s Mailing Address 8770 BECCA PT
City CORDOVA
State TN
ZIP 38016
Accounting period End 12
Primary contact name CALVIN KACEE FRANKLIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CALVIN FRANKLIN
REGISTERED AGENT, PRESIDENT, CEO
8770 BECCA PT
CORDOVA TN 38016

Officer/Director/Trustee Two

JAMES HENDERSON
DIRECTOR, SECRETARY
2893 N HARRIS CIRCLE
MEMPHIS TN 38114

Officer/Director/Trustee Three

KERMIT MADISON
DIRECTOR, TREASURER
4147 S TRIPLE CROWN LOOP
SOUTHAVEN MS 38671

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/1/2016
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P99 - Human Services - Multipurpose and Other N.E.C.
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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
Signature Title
Signature Date

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