FORM 1023-EZ for DEEP WELL SUSTAINABLE LEADERSHIP

Field Data
EIN 85-3099186
Case Number EO-2020310-000369
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name DEEP WELL SUSTAINABLE LEADERSHIP
Organization’s Mailing Address 3503 N MAIN ST
City SOQUEL
State CA
ZIP 95073
Accounting period End 12
Primary contact name KELLI GOTTHARDT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KELLI GOTTHARDT
PRESIDENT
3503 N MAIN ST
SOQUEL CA 95073

Officer/Director/Trustee Two

HEIDI BLOMBERG
TREASURER
2100 W SUNCREST DR
BOISE ID 83705

Officer/Director/Trustee Three

HALA SAAD
SECRETARY
414 MILLS ST
FORT WORTH TX 76102

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/18/2020
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W70 - Leadership Development
Organization’s purpose Charitable: Yes
Religious: Yes
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name KELLI GOTTHARDT
Signature Title PRESIDENT
Signature Date 11/3/2020

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