FORM 1023-EZ for DEEP WELL FOUNDATION
| Field | Data |
|---|---|
| EIN | 85-2075888 |
| Case Number | EO-2021076-000789 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | DEEP WELL FOUNDATION |
| Organization’s Mailing Address | 610 SPRING STREET |
| City | JAMESTOWN |
| State | NY |
| ZIP | 14701 |
| Accounting period End | 12 |
| Primary contact name | REGINA L BRACKMAN |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
REGINA L BRACKMAN
PRESIDENT
11 GENESEE STREET
JAMESTOWN NY 14701
Officer/Director/Trustee Two
REGINALD D SMITH JR
BOARD MEMBER
24 CHERRY AVE
FALCONER NY 14733
Officer/Director/Trustee Three
RAVEN LOVE THOMPSON
BOARD MEMBER
111 NEWTON AVE
JAMESTOWN NY 14701
| Organization’s website | |
|---|---|
| Organization’s email | BRACKMANREGINA@YAHOO.COM |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 8/10/2020 |
| Organization Incorporation State | NY |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | P11 - Single Organization Support |
| Organization’s purpose | Charitable: Yes Religious: No 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 | 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 | REGINA L BRACKMAN |
| Signature Title | PRESIDENT |
| Signature Date | 1/19/2021 |
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