FORM 1023-EZ for PATH NIRVANA FOUNDATION

Field Data
EIN 47-5272894
Case Number EO-2015300-000135
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PATH NIRVANA FOUNDATION
Organization’s Mailing Address 4745 WHEELER DR
City FREMONT
State CA
ZIP 94538
Accounting period End 12
Primary contact name UDANA RATNABHARATHI
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

UDANA RATNABHARATHI
SECRETARY
4745 WHEELER DR
FREMONT CA 94538

Officer/Director/Trustee Two

LAL SENANAYAKE
PRESIDENT
2232 CHARLOTTE AV
CONCORD CA 94518

Officer/Director/Trustee Three

GAYAN POTHUHERA
TREASURER
1274 ST LUIS DR
CONCORD CA 94518

Organization’s website PATHNIRVANA.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/8/2015
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
Organization’s purpose Charitable: Yes
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 No
Donation of funds No
Conducting Activities Outside of United States Yes
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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