FORM 1023-EZ for PANCHVATI ASHRAM DHAM INC

Field Data
EIN 47-5343121
Case Number EO-2015317-000191
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PANCHVATI ASHRAM DHAM INC
Organization’s Mailing Address 9062 202ND ST
City HOLLIS
State NY
ZIP 11423
Accounting period End 12
Primary contact name SANDEEP RATHEE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DWARKA MADAN
PRESIDENT
9062 202ND ST
HOLLIS NY 11423

Officer/Director/Trustee Two

SOOKLAL NIRHOE
DIRECTOR
9062 202ND ST
HOLLIS NY 11423

Officer/Director/Trustee Three

NATHURAM SHIRREKRISENGEE
DIRECTOR
9062 202ND ST
HOLLIS NY 11423

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/15/2015
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X70 - Hindu
Organization’s purpose Charitable: Yes
Religious: Yes
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 No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance Yes
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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