FORM 1023-EZ for DIABETES FREE LIFE

Field Data
EIN 81-3633668
Case Number EO-2016264-000090
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name DIABETES FREE LIFE
Organization’s Mailing Address 969 EUCLID DR
City ALLEN
State TX
ZIP 75013
Accounting period End 12
Primary contact name YATIN KARNIK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

HITESH SAIJPAL
PRESIDENT
7080 WOODED LAKE DR
SAN JOSE CA 95120

Officer/Director/Trustee Two

USHA PERI
VICE PRESIDENT
2611 KING ARTHUR BLVD
LEWISVILLE TX 75056

Officer/Director/Trustee Three

RAMKUMAR SANKARANARAYANAN
SECRETARY
3225 PARKHURST LANE
RICHARDSON TX 75082

Officer/Director/Trustee Four

YATIN KARNIK
CHIEF OPERATING OFFICER
969 EUCLID DR
ALLEN TX 75013

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/22/2016
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G80 - Specifically Named Diseases
Organization’s purpose Charitable: Yes
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 Yes
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
Signature Title
Signature Date

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