FORM 1023-EZ for UW INDIAN STUDENT ASSOCIATION

Field Data
EIN 84-2474877
Case Number EO-2019205-000376
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name UW INDIAN STUDENT ASSOCIATION
Organization’s Mailing Address 4328 7TH AVE NE APT 202
City SEATTLE
State WA
ZIP 98105
Accounting period End 6
Primary contact name DIVYA PUVVADI
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DIVYA PUVVADI
PRESIDENT
22323 SE 20TH ST
SAMMAMISH WA 98075

Officer/Director/Trustee Two

ANJALI AGARWAL
SECRETARY
22401 SE 31ST PLACE
SAMMAMISH WA 98075

Officer/Director/Trustee Three

KARTHIKYOKESH JAYAKUMAR
TREASURER
1431 140TH PLACE SW
LYNNWOOD WA 98087

Officer/Director/Trustee Four

NITYA TOLANI
VICE PRESIDENT
4328 7TH AVE NE APT 202
SEATTLE WA 98105

Organization’s website
Organization’s email UWISA@UW.EDU
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/18/19
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A23 - Cultural, Ethnic Awareness
Organization’s purpose Charitable: Yes
Religious: Yes
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 No
Conducting Activities Outside of United States No
Financial transactions with officers Yes
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 DIVYA PUVVADI
Signature Title PRESIDENT
Signature Date 7/22/19

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