FORM 1023-EZ for FAIR LAKES YOUTH ASSOCIATION

Field Data
EIN 82-3166544
Case Number EO-2018030-000270
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name FAIR LAKES YOUTH ASSOCIATION
Organization’s Mailing Address 4823 CHRISTIE JANE LANE
City FAIRFAX
State VA
ZIP 22030
Accounting period End 9
Primary contact name UMARANI MOHANRAJU
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RITU MANCHANDA
DIRECTOR
4823 CHRISTIE JANE LANE
FAIRFAX VA 22030

Officer/Director/Trustee Two

UMARANI MOHANRAJU
DIRECTOR
5665 LONESOME DOVE CT
CLIFTON VA 20124

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/17/17
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
Organization’s purpose Charitable: No
Religious: No
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 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 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 UMARANI MOHANRAJU
Signature Title DIRECTOR
Signature Date 1/28/18

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