FORM 1023-EZ for REBECCA MELVIN FOUNDATION

Field Data
EIN 47-5632105
Case Number EO-2016060-000198
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name REBECCA MELVIN FOUNDATION
Organization’s Mailing Address 300 BARR HARBOR DR STE 705
City WEST CONSHOHOCKEN
State PA
ZIP 19428
Accounting period End 12
Primary contact name CHRIS MCGRATH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DIANNE MELVIN
TREASURER
57 N SPRING LANE
PHOENIXVILLE PA 19460

Officer/Director/Trustee Two

GEORGE SUCHER
PRESIDENT
4 KIRKCALDY DR
WEST CHESTER PA 19382

Officer/Director/Trustee Three

TIMITHY IRVINE
SECRETARY
300 BARR HARBOR DR
W CONSHOHOCKEN PA 19428

Organization’s website
Organization’s email CHRIS.MCGRATH@RAZOR-TECH.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/13/2015
Organization Incorporation State PA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E60 - Health Support Services
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 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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