FORM 1023-EZ for HAWAII FAMILY CAREGIVER COALITION

Field Data
EIN 81-2079977
Case Number EO-2016201-000523
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HAWAII FAMILY CAREGIVER COALITION
Organization’s Mailing Address 2630 OAHU AVENUE
City HONOLULU
State HI
ZIP 96822
Accounting period End 12
Primary contact name BRIAN EZUKA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

GARY SIMON
DIRECTOR/PRESIDENT
2630 OAHU AVENUE
HONOLULU HI 96822

Officer/Director/Trustee Two

ELDON WEGNER
DIRECTOR/VICE PRESIDENT
2333 KAPIOLANI BLVD NO 2413
HONOLULU HI 96826

Officer/Director/Trustee Three

CULLEN HAYASHIDA
DIRECTOR/TREASURER
2233 ALA MAHAMOE STREET
HONOLULU HI 96819

Officer/Director/Trustee Four

FELICIA MARQUEZ-WONG
DIRECTOR
3227 ALA LAULANI STREET
HONOLULU HI 96818

Officer/Director/Trustee Five

LYN MOKU
DIRECTOR
1941 CHURCH LANE NO 41
HONOLULU HI 96826

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/18/2014
Organization Incorporation State HI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P40 - Family 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 Yes
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
Signature Title
Signature Date

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