FORM 1023-EZ for MADAME MERMAID CLUB INC

Field Data
EIN 83-2125752
Case Number EO-2019037-000807
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MADAME MERMAID CLUB INC
Organization’s Mailing Address PO BOX 37624
City HONOLULU
State HI
ZIP 96837
Accounting period End 12
Primary contact name NORIKO NIXON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

NORIKO NIXON
MEMBER
232 KAIULANI AVE APT 602A
HONOLULU HI 96815

Officer/Director/Trustee Two

SHARON SUZUKI
MEMBER
5210 LIKINI ST
HONOLULU HI 96818

Officer/Director/Trustee Three

MARY BREWER
MEMBER
91-1462 RENTON RD APT 4
EWA BEACH HI 96706

Organization’s website WWW.MADAMEMERMAIDCLUB.ORG
Organization’s email MADAMEMERMAIDCLUB@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/1/18
Organization Incorporation State HI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P81 - Senior Centers, Services
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name NORIKO NIXON
Signature Title MEMBER
Signature Date 1/29/19

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