FORM 1023-EZ for KUKUI INTEGRATIVE MEDICINE

Field Data
EIN 84-2776565
Case Number EO-2019261-000071
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name KUKUI INTEGRATIVE MEDICINE
Organization’s Mailing Address PO BOX 312
City CAPTAIN COOK
State HI
ZIP 96704
Accounting period End 12
Primary contact name JODI LESLIE MATSUO
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JODI LESLIE MATSUO
CEO, PRESIDENT
PO BOX 312
CAPTAIN COOK HI 96704

Officer/Director/Trustee Two

LEON MATSUO
CFO, VICE PRESIDENT
PO BOX 312
CAPTAIN COOK HI 96704

Officer/Director/Trustee Three

KARL MURASHIMA
SECRETARY
73-1178 ALA KAPUA STREET
KAILUA-KONA HI 96740

Officer/Director/Trustee Four

MARILYN MURASHIMA
TREASURER
73-1178 ALA KAPUA STREET
KAILUA-KONA HI 96740

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/19/19
Organization Incorporation State HI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E70 - Public Health Program (Includes General Health and Wellness Promotion Services)
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee Yes
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 JODI LESLIE MATSUO
Signature Title CEO, PRESIDENT
Signature Date 9/16/19

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