FORM 1023-EZ for BLUE STAR HEALTH INC

Field Data
EIN 85-2055990
Case Number EO-2020209-000692
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BLUE STAR HEALTH INC
Organization’s Mailing Address 1154 LEE BLVD UNIT 3
City LEHIGH ACRES
State FL
ZIP 33936
Accounting period End 12
Primary contact name FABIO RUIZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

FABIO RUIZ
PRESIDENT
1154 LEE BLVD UNIT 3
LEHIGH ACRES FL 33936

Organization’s website WWW.BLUESTARHEALTH.ORG
Organization’s email AP@BLUESTARHEALTH.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/17/2020
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E21 - Community Health Systems
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: Yes
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 FABIO RUIZ
Signature Title PRESIDENT
Signature Date 7/20/2020

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