FORM 1023-EZ for UU WELLSPRING

Field Data
EIN 47-5280076
Case Number EO-2016006-000232
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name UU WELLSPRING
Organization’s Mailing Address 3400 DUPONT AVE S
City MINNEAPOLIS
State MN
ZIP 55408
Accounting period End 6
Primary contact name JEN CROW
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DAVID MUNRO
BOARD MEMBER
82 MEADOWLAND ST
DELMAR NY 12054

Officer/Director/Trustee Two

JEN CROW
TREASURER
3708 PLEASANT AVE
MINNEAPOLIS MN 55409

Officer/Director/Trustee Three

ELIZABETH MOORE
BOARD MEMBER
23 BROOK HOLLOW
PITTSFORD NY 14534

Officer/Director/Trustee Four

SARAH SMALLEY
CHAIR
4412 FONDELL DRIVE
EDINA MN 55435

Officer/Director/Trustee Five

DEBORAH RAIBLE
BOARD MEMBER
1704 36TH AVE
SEATTLE WA 98122

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/18/2015
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X99 - Religion Related, Spiritual Development N.E.C.
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 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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