FORM 1023-EZ for PROJECT HEALTHY MINDS INC

Field Data
EIN 83-0871069
Case Number EO-2018222-000237
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PROJECT HEALTHY MINDS INC
Organization’s Mailing Address 1735 N FIRST ST STE 302
City SAN JOSE
State CA
ZIP 95112-4511
Accounting period End 12
Primary contact name SHYAM GOPAL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHRUTHI SHYAM
CEO
19018 MELLON DR
SARATOGA CA 95070-3518

Officer/Director/Trustee Two

SHYAM GOPAL
CFO
19018 MELLON DR
SARATOGA CA 95070-3518

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/30/18
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F21 - Alcohol, Drug Abuse, Prevention Only
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 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 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 SHYAM GOPAL
Signature Title CFO
Signature Date 8/7/18

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