FORM 1023-EZ for JPS MEDAID INTERNATIONAL ORG

Field Data
EIN 46-4506914
Case Number EO-2015259-000262
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name JPS MEDAID INTERNATIONAL ORG
Organization’s Mailing Address 844 WINTON DRIVE
City PETALUMA
State CA
ZIP 94954
Accounting period End 6
Primary contact name SUBRATA SAHA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

SUBRATA SAHA
DIRECTOR
4175 BLACKROCK DRIVE
DUBLIN CA 94568

Officer/Director/Trustee Two

SUMONA BAGCHI
DIRECTOR
1048 WHITEBICK DRIVE
SAN JOSE CA 95129

Officer/Director/Trustee Three

ASISH SENGUPTA
DIRECTOR
230 LANGLIE CT
WALNUT CREEK CA 94598

Organization’s website JPSINTERNATIONAL.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/25/2013
Organization Incorporation State CA
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 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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