FORM 1023-EZ for MINDFUL HAWAII INC

Field Data
EIN 81-3683997
Case Number EO-2016251-000162
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MINDFUL HAWAII INC
Organization’s Mailing Address 1662 OHAWAI PLACE
City HONOLULU
State HI
ZIP 96821
Accounting period End 12
Primary contact name JESSE JONES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JAMES TOYAMA
PRESIDENT
98-427 PUAALII ST
AIEA HI 96701

Officer/Director/Trustee Two

RICHARD HENNESSEY
VICE-PRESIDENT
3008 LIBERT ST
HONOLULU HI 96816

Officer/Director/Trustee Three

JESSE JONES
SECRETARY-TREASURER
1662 OHAWAI PL
HONOLULU HI 96821

Organization’s website MINDFULHAWAII.ORG
Organization’s email jj42aol@gmail.com
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/18/2016
Organization Incorporation State HI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X99 - Religion Related, Spiritual Development N.E.C.
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
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
Signature Title
Signature Date

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