FORM 1023-EZ for THE WELLSPRING FOUNDATION FOR RENEWAL INC

Field Data
EIN 85-1169433
Case Number EO-2021019-000128
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name THE WELLSPRING FOUNDATION FOR RENEWAL INC
Organization’s Mailing Address 60 SPEWAK RD
City WAYMART
State PA
ZIP 18472
Accounting period End 12
Primary contact name MICHAEL CORSINI
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MICHAEL CORSINI
DIRECTOR/PRESIDENT
60 SPEWAK RD
WAYMART PA 18472

Officer/Director/Trustee Two

ANDREW POCTA
TREASURER
620 WOODSTOCK ROAD
VIRGINIA BEACH VA 23464

Officer/Director/Trustee Three

JEFF MAZZONE
SECRETARY
16 CHAPPAQUA ROAD
CARMEL NY 10512

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/13/2020
Organization Incorporation State PA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X22 - Roman Catholic
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 No
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 MICHAEL CORSINI
Signature Title DIRECTOR/PRESIDENT
Signature Date 11/25/2020

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