FORM 1023-EZ for THE MAHALO HOME FOUNDATION

Field Data
EIN 81-1969524
Case Number EO-2016091-000651
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name THE MAHALO HOME FOUNDATION
Organization’s Mailing Address 2696 TERI TERRACE
City EAST LANSING
State MI
ZIP 48823
Accounting period End 12
Primary contact name BRUCE WARREN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

BRUCE WARREN
MR
2696 TERI TERRACE
EAST LANSING MI 48823

Officer/Director/Trustee Two

BOZENA STRAK-WARREN
MRS.
2696 TERI TERRACE
EAST LANSING MI 48823

Officer/Director/Trustee Three

RUTH BURGETT
MRS.
715 LINDEN STREET
EAST LANSING MI 48823

Officer/Director/Trustee Four

JOHN BURGETT
MR
715 LINDEN STREET
EAST LANSING MI 48823

Officer/Director/Trustee Five

DIANE CRAIG
MRS.
3635 CRAIN ROAD
ONONDAGA MI 49264

Organization’s website
Organization’s email BRUCEANDBOZENA@COMCAST.NET
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/28/2016
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P73 - Group Home (Long Term)
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 No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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