FORM 1023-EZ for MIRABAI NOMAD

Field Data
EIN 81-0747751
Case Number EO-2020024-000338
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MIRABAI NOMAD
Organization’s Mailing Address 302 GREAT ROAD
City STOW
State MA
ZIP 01775
Accounting period End 12
Primary contact name STACEY MARTIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JENNIFER BARLOW
TREASURER
6 GOOSE POND ROAD
LINCOLN MA 01773

Officer/Director/Trustee Two

MALINI SEKHAR
SECRETARY
107 CAHILL DRIVE
ALEXANDRIA VA 22304

Officer/Director/Trustee Three

AKEMI TAKAHASHI
OFFICER
562 2 YAMACA UBUYAMA ASO KUMAMOTO
JAPAN

Officer/Director/Trustee Four

MAGANO NERI
OFFICER
PO BOX 80121 WINDHOEK
NAMIBIA

Officer/Director/Trustee Five

STACEY MARTIN
PRESIDENT
302 GREAT ROAD
STOW MA 01775

Organization’s website
Organization’s email STACEY@DAKINIRISING.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/20/2015
Organization Incorporation State MA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Q30 - International Development, Relief 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 Yes
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name STACEY MARTIN
Signature Title PRESIDENT
Signature Date 1/22/2020
EIN 81-0747751
Case Number EO-2016201-000520
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MIRABAI NOMAD
Organization’s Mailing Address 302 GREAT ROAD
City STOW
State MA
ZIP 01775
Accounting period End 12
Primary contact name STACEY MARTIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

STACEY MARTIN
DIRECTOR
302 GREAT ROAD
STOW MA 01775

Officer/Director/Trustee Two

AKEMI TAKAHASHI
PRESIDENT
562 2 YAMAGA UBUYAMA ASO KUMAMOTO
JAPAN

Officer/Director/Trustee Three

MICHIYO OHARA
TREASURER
253 HASHIMOTO CHO YOKOHAMA KANAGAWA
JAPAN

Officer/Director/Trustee Four

MALINI SEKHAR
OFFICER
107 CAHILL DRIVE
ALEXANDRIA VA 22304

Officer/Director/Trustee Five

LAURA HAUGHEY
OFFICER
5 RHODE ISLAND AVE
PROVIDENCE RI 02906

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/20/2015
Organization Incorporation State MA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Q30 - International Development, Relief 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 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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