FORM 1023-EZ for SAI SHIV MANDIR AND SPIRITUAL COMMUNITY CENTER

Field Data
EIN 85-3392454
Case Number EO-2020295-001006
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SAI SHIV MANDIR AND SPIRITUAL COMMUNITY CENTER
Organization’s Mailing Address 8872 JODY LN APT 1C
City DES PLAINES
State IL
ZIP 60016
Accounting period End 12
Primary contact name HEMRAJ DUBEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

HEMRAJ DUBEY
PRESIDENT
8872 JODY LN APT 1C
DES PLAINES IL 60016

Officer/Director/Trustee Two

LAXMI DUBEY
SECRETARY
8872 JODY LN APT 1C
DES PLAINES IL 60016

Officer/Director/Trustee Three

JEEVAN RAM
TRAESURER
6229 N TALMAN
CHICAGO IL 60659

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/9/2020
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X02 - Management & Technical Assistance
Organization’s purpose Charitable: Yes
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 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 HEMRAJ DUBEY
Signature Title PRESIDENT
Signature Date 10/15/2020

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