FORM 1023-EZ for MAINESTREAM WELLNESS

Field Data
EIN 81-5158383
Case Number EO-2021242-000690
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MAINESTREAM WELLNESS
Organization’s Mailing Address 9 RAM ISLAND FARM ROAD
City CAPE ELIZABETH
State ME
ZIP 04107
Accounting period End 12
Primary contact name SHAW SPRAGUE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHAW SPRAGUE
PRESIDENT AND DIRECTOR
9 RAM ISLAND FARM ROAD
CAPE ELIZABETH ME 04107

Officer/Director/Trustee Two

THOMAS LEPLEY
TREASURER AND DIRECTOR
2435 BASELINE AVENUE
BALLARD CA 93463

Officer/Director/Trustee Three

KENNETH DONG
SECRETARY AND DIRECTOR
70 BEACH STREET
BOSTON MA 02111

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/2/2016
Organization Incorporation State ME
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E70 - Public Health Program (Includes General Health and Wellness Promotion Services)
Organization’s purpose Charitable: No
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name SHAW SPRAGUE
Signature Title PRESIDENT AND DIRECTOR
Signature Date 8/27/2021

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