FORM 1023-EZ for MY BROTHERS KEEPER HAWAII

Field Data
EIN 81-3342547
Case Number EO-2018095-000567
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MY BROTHERS KEEPER HAWAII
Organization’s Mailing Address PO BOX 970035
City WAIPAHU
State HI
ZIP 96797
Accounting period End 12
Primary contact name CAROLYN VILLAMOR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CAROLYN VILLAMOR
PRESIDENT/TREASURER
PO BOX 970035
WAIPAHU HI 96797

Officer/Director/Trustee Two

SARAH PAIKAI
VICE PRESIDENT/SECRETARY
PO BOX 4532
KANEOHE HI 96744

Officer/Director/Trustee Three

LANDEN PAIKAI
DIRECTOR
PO BOX 4532
KANEOHE HI 96744

Officer/Director/Trustee Four

KAJANA MOVERY
DIRECTOR
PO BOX 4532
KANEOHE HI 96744

Officer/Director/Trustee Five

JACQUELINE HARRIS
DIRECTOR
PO BOX 970035
WAIPAHU HI 96797

Organization’s website WWW.STELLARCARE4VETS.COM
Organization’s email MBKH808@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/15/16
Organization Incorporation State HI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code J99 - Employment, Job Related N.E.C.
Organization’s purpose Charitable: Yes
Religious: No
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 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 CAROLYN VILLAMOR
Signature Title PRESIDENT/TREASURER
Signature Date 3/21/18

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