FORM 1023-EZ for LEHUALANI CENTER

Field Data
EIN 81-4691053
Case Number EO-2017205-000002
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LEHUALANI CENTER
Organization’s Mailing Address 760 S KIHEI RD UNIT 502
City KIHEI
State HI
ZIP 96753-7520
Accounting period End 12
Primary contact name SARAH M WILLIAMS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SARAH WILLIAMS
PRESIDENT
760 S KIHEI RD UNIT 520
KIHEI HI 96753-7520

Officer/Director/Trustee Two

SARAH WILLIAMS
SECRETARY
760 S KIHEI RD UNIT 502
KIHEI HI 96753-7520

Officer/Director/Trustee Three

SARAH WILLIAMS
TREASURER
760 S KIHEI RD UNIT 502
KIHEI HI 96753-7520

Organization’s website
Organization’s email SARAHWILLIAMSPSYD@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/14/2016
Organization Incorporation State HI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F32 - Community Mental Health Center
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 Yes
Donation of funds No
Conducting Activities Outside of United States No
Financial transactions with officers Yes
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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