FORM 1023-EZ for HOLO I KA MUA

Field Data
EIN 83-1743863
Case Number EO-2018247-000712
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HOLO I KA MUA
Organization’s Mailing Address 86-031 HOAHA PLACE
City WAIANAE
State HI
ZIP 96792
Accounting period End 12
Primary contact name JENNIFER ADVERSALO
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RYAN ADVERSALO
DIRECTOR/PRESIDENT
86-031 HOAHA PLACE
WAIANAE HI 96792

Officer/Director/Trustee Two

LYNDA KERNAGHAN
DIRECTOR/VICE PRESIDENT
91-525 PUAMAEOLE STREET 37C
EWA BEACH HI 96706

Officer/Director/Trustee Three

SIRE REPOLIO
DIRECTOR/SECRETARY
1945 KINIKOHU STREET
WAHIAWA HI 96786

Officer/Director/Trustee Four

JENNIFER ADVERSALO
TREASURER
86-031 HOAHA PLACE
WAIANAE HI 96792

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/18/18
Organization Incorporation State HI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P12 - Fund Raising and/or Fund Distribution
Organization’s purpose Charitable: Yes
Religious: No
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 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 RYAN ADVERSALO
Signature Title DIRECTOR/PRESIDENT
Signature Date 8/31/18

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