FORM 1023-EZ for LOTUS ISLAND OASIS

Field Data
EIN 84-4989034
Case Number EO-2021100-000593
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LOTUS ISLAND OASIS
Organization’s Mailing Address 43-2058 PAAUILO MAUKA ROAD BOX 427
City PAAUILO
State HI
ZIP 96776
Accounting period End 3
Primary contact name LOTUS OASIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CHERYL PASCUAL
SECRETARY
43-2058 PAAUILO MAUKA ROAD
PAAUILO HI 96776

Officer/Director/Trustee Two

JENNIFER ERICKSON
FOUNDER/DIRECTOR
4621 NE 22ND ST
PORTLAND OR 97211

Officer/Director/Trustee Three

LIYSA SWART
FOUNDER/DIRECTOR
43-2058 PAAUILO MAUKA ROAD
PAAUILO HI 96776

Officer/Director/Trustee Four

TAMMY KNUDSEN
ADVISOR
SPECTRUM CENTER
IRVINE CA 98261

Organization’s website WWW.LOTUSISLANDOAIS.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/26/2020
Organization Incorporation State HI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F99 - Mental Health, Crisis Intervention 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 Yes
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 LIYSA SWART
Signature Title FOUNDER/DIRECTOR
Signature Date 3/25/2021

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