FORM 1023-EZ for WELLSPRING DISCIPLESHIP MINISTRIES

Field Data
EIN 81-5221764
Case Number EO-2017065-000235
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name WELLSPRING DISCIPLESHIP MINISTRIES
Organization’s Mailing Address P O BOX 489
City JOELTON
State TN
ZIP 37080
Accounting period End 12
Primary contact name BONNI SKIPWORTH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BONNI K SKIPWORTH
PRESIDENT
P O BOX 489
JOELTON TN 37080

Officer/Director/Trustee Two

TINA L MELTON
SECRETARY
2464 UNION HILL ROAD
GOODLETTSVILLE TN 37072

Officer/Director/Trustee Three

FRED A BRUMBACH
TREASURER
159 TARA LANE
GOODLETTSVILLE TN 37072

Officer/Director/Trustee Four

ROGER D MELTON
DIRECTOR
2464 UNION HILL ROAD
GOODLETTSVILLE TN 37072

Officer/Director/Trustee Five

JULIUS KENT YOUNG SR
DIRECTOR
201 RIVERCHASE BLVD
MADISON TN 37115

Organization’s website WWW.WELLSPRINGDISCIPLESHIPMINISTRIES.COM
Organization’s email BONNISKIPWORTH@COMCAST.NET
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/3/2017
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X20 - Christian
Organization’s purpose Charitable: No
Religious: Yes
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 Yes
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
Signature Title
Signature Date

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