FORM 1023-EZ for TEAM EVEREST USA

Field Data
EIN 84-2421511
Case Number EO-2020261-000053
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name TEAM EVEREST USA
Organization’s Mailing Address 1315 270TH LN SE
City SAMMAMISH
State WA
ZIP 98075-5968
Accounting period End 12
Primary contact name CHANDRA POLISETTI
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CHANDRA POLISETTI
PRESIDENT
1315 270TH LN SE
SAMMAMISH WA 98075-5968

Officer/Director/Trustee Two

ARAVINDAKUMAR VENUGOPALAN
SECRETARY
607 B COUNTRY CLUB PKWY
MOUNT LAUREL NJ 08054

Officer/Director/Trustee Three

VEDHAVALLI KUNCHITHAPATHAM
TREASURER
780 JOHN COURT
LAKE ZURICH IL 60047

Organization’s website
Organization’s email INFO@TEAMEVERESTUSA.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/17/2019
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T50 - Philanthropy, Charity, Voluntarism Promotion, General
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 No
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 Yes
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 CHANDRA POLISETTI
Signature Title PRESIDENT
Signature Date 9/15/2020

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