FORM 1023-EZ for WELLSPRINGS SERVICE GROUP INC

Field Data
EIN 84-1801880
Case Number EO-2019196-000132
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name WELLSPRINGS SERVICE GROUP INC
Organization’s Mailing Address 75 FERRY HILL DRIVE
City SOMERSET
State KY
ZIP 42503
Accounting period End 12
Primary contact name TRICIA WHITAKER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CRAIG WHITAKER
DIRECTOR
75 FERRY HILL DRIVE
SOMERSET KY 42503

Officer/Director/Trustee Two

TRICIA WHITAKER
OFFICER
75 FERRY HILL DRIVE
SOMERSET KY 42503

Officer/Director/Trustee Three

KATHY MCKEE
OFFICER
370 SLOANS VALLEY RD
BURNSIDE KY 42519

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/17/19
Organization Incorporation State KY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F60 - Counseling, Support Groups
Organization’s purpose Charitable: Yes
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name CRAIG WHITAKER
Signature Title DIRECTOR
Signature Date 7/11/19

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