FORM 1023-EZ for HAWA

Field Data
EIN 80-0682005
Case Number EO-2017041-000260
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HAWA
Organization’s Mailing Address PO BOX 10572
City HILO
State HI
ZIP 96721-0572
Accounting period End 12
Primary contact name RACHIEL JAVINE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RACHIEL JAVINE
CEO
PO BOX 10572
HILO HI 96721-0572

Officer/Director/Trustee Two

ANNABEL MURRAY
CAO
788 BISHOP ST
HONOLULU HI 96813

Officer/Director/Trustee Three

MICHELLE MCBRAUN
CFO
PO BOX 492486
KEAAU HI 96749-4924

Organization’s website WWW.HISN808.ORG
Organization’s email HISN808@HOTMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/24/2016
Organization Incorporation State HI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P99 - Human Services - Multipurpose and Other N.E.C.
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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