FORM 1023-EZ for WAIMANALO YOUTH AND FAMILY COLLABORATIVE

Field Data
EIN 99-0264205
Case Number EO-2014293-000172
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name WAIMANALO YOUTH AND FAMILY COLLABORATIVE
Organization’s Mailing Address PO BOX 21
City WAIMANALO
State HI
ZIP 96795-0021
Accounting period End 12
Primary contact name SUSAN GALL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

GWEN KAILILIHIWA
DIRECTOR - PRESIDENT
41-912 OLUOLU
WAIMANALO HI 96795-1516

Officer/Director/Trustee Two

KEHAULANI PADILLA
DIRECTOR - VICE PRESIDENT
41-245 ILAUHOLE STREET
WAIMANALO HI 96795-1778

Officer/Director/Trustee Three

SUSAN GALL
DIRECTOR -TREASURER
130 Kakahiaka St
Kailua HI 96734-3459

Officer/Director/Trustee Four

SHANTEL WILCOX
DIRECTOR
41-912 OLUOLU
WAIMANALO HI 96795-1516

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/16/2009
Organization Incorporation State HI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O99 - Youth Development N.E.C.
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: Yes
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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