FORM 1023-EZ for HISIS

Field Data
EIN 85-3933573
Case Number EO-2021104-000874
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HISIS
Organization’s Mailing Address 427 PAU STREET
City HONOLULU
State HI
ZIP 96815
Accounting period End 12
Primary contact name PATRICK BATTANI
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PATRICK BATTANI
PARTNER
427 PAU STREET
HONOLULU HI 96815

Officer/Director/Trustee Two

NATALIE MARK
PARTNER
277 OHUA AVE
HONOLULU HI 96815

Organization’s website www.hisis.org
Organization’s email patricio@hisis.org
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/17/2020
Organization Incorporation State HI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E60 - Health Support 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 No
Compensation of Officer director trustee Yes
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 No
Correctness Declaration Yes
Signature Name PATRICK BATTANI
Signature Title PARTNER
Signature Date 4/12/2021

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