FORM 1023-EZ for KERALA MUSLIM COMMUNITY ASSOCIATIONINC

Field Data
EIN 81-3428066
Case Number EO-2016326-000030
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name KERALA MUSLIM COMMUNITY ASSOCIATIONINC
Organization’s Mailing Address 5869 JARVIS AVE
City NEWARK
State CA
ZIP 94560
Accounting period End 12
Primary contact name ASIF ERAYATH THEKKE VALAPPIL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ASIF ERAYATH THEKKE VALAPPIL
PRESIDENT
1017 N ABBOT AVE
MILPITAS CA 95035

Officer/Director/Trustee Two

MOHAMMED BAFAKYH
VICE PRESIDENT
1679 WHISPERING WIND DR
TRACY CA 95377

Officer/Director/Trustee Three

SHANAVAS PODUVATH
SECRETARY
460 W CAMPANIA WAY
MOUNTAIN HOUSE CA 95391

Officer/Director/Trustee Four

MOHAMMED FAISAL CHEMBAN
TREASURER
6926 CORTE MATEO
PLEASANTON CA 94566

Organization’s website
Organization’s email LIMBERLAIN@UNITED.TAX
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/18/2016
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P99 - Human Services - Multipurpose and Other 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 Yes
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 No
One Third Support Gifts Yes
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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