FORM 1023-EZ for OMNISAI

Field Data
EIN 83-4502018
Case Number EO-2019126-000469
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name OMNISAI
Organization’s Mailing Address 4000 PIMLICO DR SUITE 114
City PLEASONTON
State CA
ZIP 94588
Accounting period End 12
Primary contact name RAMAN RANGARAJAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

VENKATA RAMA MOHAN RAO POTHABATHULA
CEO AND TREASURER
4000 PIMLICO DR SUITE 114
PLEASONTON CA 94588

Officer/Director/Trustee Two

ARUNAKUMARI YELLAPU
SECRETARY
4000 PIMLICO DR SUITE 114
PLEASONTON CA 94588

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/10/19
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X04 -
Organization’s purpose Charitable: No
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 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 VENKATA RAMA MOHAN RAO POTHABATHULA
Signature Title CEO AND TREASURER
Signature Date 5/3/19

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