FORM 1023-EZ for MCBH FCPOA

Field Data
EIN 87-1994779
Case Number EO-2021274-000071
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MCBH FCPOA
Organization’s Mailing Address SURG CO B 3D MEDICAL BN BOX 63038
City KANEOHE BAY
State HI
ZIP 96863
Accounting period End 12
Primary contact name MARC PETRINO
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MARC PETRINO
TREASURER
SURG CO B 3D MEDICAL BN BOX 63038
KANEOHE BAY HI 96863

Officer/Director/Trustee Two

JONATHAN FALETOI
PRESIDENT
SURG CO B 3D MEDICAL BN BOX 63038
KANEOHE BAY HI 96863

Organization’s website
Organization’s email MARC.PETRINO@USMC.MIL
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/26/2021
Organization Incorporation State HI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W30 - Military, Veterans' Organizations
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 Yes
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement Yes
Correctness Declaration No
Signature Name MARC PETRINO
Signature Title TREASURER
Signature Date 9/30/2021

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