FORM 1023-EZ for SYMBIOSIS LABORATORY EDUCATION

Field Data
EIN 82-1943664
Case Number EO-2018169-000683
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SYMBIOSIS LABORATORY EDUCATION
Organization’s Mailing Address 21216 SE 25TH ST
City SAMMAMISH
State WA
ZIP 98075
Accounting period End 12
Primary contact name NIKHIL KAZA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SAI NIKHIL KAZA
PRESIDENT
21216 SE 25TH ST
SAMMAMISH WA 98075

Officer/Director/Trustee Two

NEVIN KALAF
VICE PRESIDENT
4231 12TH AVE NE
SEATTLE WA 98105

Officer/Director/Trustee Three

JASMINE SHEN
SECRETARY
16115 SE 45TH CT
BELLEVUE WA 98006

Organization’s website SYMBIOSISLABEDUCATION.ORG
Organization’s email INFO@SYMBIOSISLABEDUCATION.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/22/17
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B28 - Specialized Education Institutions
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
Scientific: Yes
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 Yes
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 SAI NIKHIL KAZA
Signature Title PRESIDENT
Signature Date 6/14/18

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