FORM 1023-EZ for MAUI MIXER

Field Data
EIN 81-0769698
Case Number EO-2015344-000508
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MAUI MIXER
Organization’s Mailing Address 678 KILIHAU STREET
City WAILUKU
State HI
ZIP 96793
Accounting period End 12
Primary contact name MAX PICHAY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MAX PICHAY
PRESIDENT / DIRECTOR
678 KILIHAU STREET
WAILUKU HI 96793

Officer/Director/Trustee Two

ACACIA DORLAND
VICE PRESIDENT / DIRECTOR
492 KAHUA PLACE
PAIA HI 96779

Officer/Director/Trustee Three

JULIA DORLAND
SECRETARY / TREASURER / DIRECTOR
492 KAHUA PLACE
PAIA HI 96779

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/4/2015
Organization Incorporation State HI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N99 - Recreation, Sports, Leisure, Athletics N.E.C.
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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