FORM 1023-EZ for SOUTHSIDE ATHLETICS

Field Data
EIN 83-4021292
Case Number EO-2019098-000059
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SOUTHSIDE ATHLETICS
Organization’s Mailing Address 41-404 EWA BEACH ROAD
City EWA BEACH
State HI
ZIP 96706
Accounting period End 12
Primary contact name DAVID PERREIRA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DAVID PERREIRA
PRESIDENT / DIRECTOR
91-404 EWA BEACH ROAD
EWA BEACH HI 96706

Officer/Director/Trustee Two

CHAMEKA CURRAN
SECRETARY / TREASURER DIRECTOR
91-1792 PAEKO STREET
EWA BEACH HI 96706

Officer/Director/Trustee Three

CLAUDE IZUKA
VP / DIRECTOR
PO BOX 1730
PEARL CITY HI 96782

Organization’s website
Organization’s email SOUTHSIDEATHLETICSHI@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/2/19
Organization Incorporation State HI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N99 - Recreation, Sports, Leisure, Athletics N.E.C.
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 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 DAVID PERREIRA
Signature Title PRESIDENT / DIRECTOR
Signature Date 4/3/19

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