FORM 1023-EZ for SAISERVE ORG

Field Data
EIN 82-0757021
Case Number EO-2017160-000218
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SAISERVE ORG
Organization’s Mailing Address 7611 TIMBERLY COURT
City MCLEAN
State VA
ZIP 22102
Accounting period End 12
Primary contact name JOE W FRAZIER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

VANDANA VAVILALA
DIRECTOR
7611 TIMBERLY COURT
MCLEAN VA 22102

Officer/Director/Trustee Two

NARENDRA SUMANAM
DIRECTOR
9411 LEE HWY 1007
FAIRFAX VA 22031

Officer/Director/Trustee Three

JOE FRAZIER
DIRECTOR
P O BOX 11139
MCLEAN VA 22102

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/13/2017
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F30 - Mental Health Treatment - Multipurpose and N.E.C.
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 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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