FORM 1023-EZ for PUA KALLIMA O KAWAIHAE CULTURAL SURFPARK INC

Field Data
EIN 91-1911938
Case Number EO-2017012-000378
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PUA KALLIMA O KAWAIHAE CULTURAL SURFPARK INC
Organization’s Mailing Address PO BOX 1725
City KAMUELA
State HI
ZIP 96743-9165
Accounting period End 12
Primary contact name BOB SIMMS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BILLY MITCHELL
PRESIDENT
POB 2003
KAMUELA HI 96743-9165

Officer/Director/Trustee Two

BOB SIMMS
VICE-PRESIDENT
PO BOX 1725
KAMUELA HI 96743-9165

Officer/Director/Trustee Three

KAWENA GOMES
SECRETARY
PO BOX 437438
KAMUELA HI 96743-9165

Officer/Director/Trustee Four

ROGER HARRIS
TREASURER
PO BOX 803
KAMUELA HI 96743-9165

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/22/1997
Organization Incorporation State HI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N32 - Parks and Playgrounds
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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