FORM 1023-EZ for HAWAII FETAL ALCOHOL SPECTRUM DISORDERS FASD ACTION GROUP

Field Data
EIN 85-1001234
Case Number EO-2020183-000476
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HAWAII FETAL ALCOHOL SPECTRUM DISORDERS FASD ACTION GROUP
Organization’s Mailing Address 47-670 HALEMANU STREET
City KANEOHE
State HI
ZIP 96744-5512
Accounting period End 12
Primary contact name ANN YABUSAKI
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ANN YABUSAKI
PRESIDENT
47670 HALEMANU STREET
KANEOHE HI 96744

Officer/Director/Trustee Two

KENICHI YABUSAKI
TREASURER
47-670 HALEMANU STREET
KANEOHE HI 96744-5512

Officer/Director/Trustee Three

CLEOTA BROWN
SECRETARY
47-713 WAIHEE ROAD
KANEOHE HI 96744-4952

Organization’s website WWW.HAWAIIFASD.ORG
Organization’s email HAWAIIFASDACTIONGROUP@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/1/2020
Organization Incorporation State HI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G20 - Birth Defects and Genetic Diseases
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 ANN YABUSAKI
Signature Title PRESIDENT
Signature Date 6/29/2020

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