FORM 1023-EZ for HAWAII AUTONOMOUS VEHICLE INSTITUTE

Field Data
EIN 83-1434721
Case Number EO-2019312-000018
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HAWAII AUTONOMOUS VEHICLE INSTITUTE
Organization’s Mailing Address 2540 DOLE STREET HOLMES 240 G
City HONOLULU
State HI
ZIP 96822
Accounting period End 12
Primary contact name MATTHEW BUCHER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ROBERT FISCHER
T/S/D
2655 RESEARCH PARK DRIVE
FITCHBURG HI 53711

Officer/Director/Trustee Two

RAYMOND MANDLI
D/VC
2655 RESEARCH DRIVE
FITCHBURG WA 53711

Officer/Director/Trustee Three

TIANWEI MA
D/AS/AT/C
2540 DOLE STREET HOLMES 240 G
HONOLULU HI 96822

Officer/Director/Trustee Four

DAVID ROLF
D
1100 ALAKEA STREET SUITE 2601
HONOLULU HI 96813

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/1/18
Organization Incorporation State HI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code M42 - Automotive Safety
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
Scientific: Yes
Literary: No
Public Safety: Yes
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 ROBERT FISCHER
Signature Title T/S/D
Signature Date 11/6/19

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